Provider Demographics
NPI:1184976169
Name:WILLITS, MINDY GAY (RN NP)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:GAY
Last Name:WILLITS
Suffix:
Gender:F
Credentials:RN NP
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Mailing Address - Street 1:499 E HAMPDEN AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3875
Mailing Address - Country:US
Mailing Address - Phone:303-788-0808
Mailing Address - Fax:720-259-4566
Practice Address - Street 1:499 E HAMPDEN AVE STE 190
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3875
Practice Address - Country:US
Practice Address - Phone:303-788-0808
Practice Address - Fax:720-259-4566
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO22446363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology