Provider Demographics
NPI:1891360558
Name:KLEINZ, CAMMIE ANN SANGEET (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CAMMIE ANN
Middle Name:SANGEET
Last Name:KLEINZ
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 W UNION AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80236-3632
Mailing Address - Country:US
Mailing Address - Phone:346-347-0967
Mailing Address - Fax:
Practice Address - Street 1:4729 OPUS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-8694
Practice Address - Country:US
Practice Address - Phone:719-289-3173
Practice Address - Fax:866-718-1677
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-RXN.0001430-C-NP363LP0808X, 2084P0804X
COC-APN.0002923-C-NP363LP0808X, 2084P0800X, 2084P0804X
TX10347972084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1034797OtherPMHNP
TX757595OtherRN
COC-APN.0002923-C-NPOtherAPN
COC-RXN.0001430-C-NPOtherCRX