Provider Demographics
NPI:1760762850
Name:NBI PAIN MANAGEMENT INSTITUTE
Entity Type:Organization
Organization Name:NBI PAIN MANAGEMENT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MAILE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-763-9017
Mailing Address - Street 1:9218 KIMMER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6732
Mailing Address - Country:US
Mailing Address - Phone:720-763-9017
Mailing Address - Fax:720-763-9027
Practice Address - Street 1:9218 KIMMER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6732
Practice Address - Country:US
Practice Address - Phone:720-763-9017
Practice Address - Fax:720-763-9027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORXP-6204363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty