Provider Demographics
NPI:1255761110
Name:PRICE, MATTHEW CHARLES (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHARLES
Last Name:PRICE
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 W 136TH AVE # 106-146
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9306
Mailing Address - Country:US
Mailing Address - Phone:303-578-2702
Mailing Address - Fax:303-484-2659
Practice Address - Street 1:7535 E HAMPDEN AVE # 407
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4838
Practice Address - Country:US
Practice Address - Phone:303-578-2702
Practice Address - Fax:303-484-2659
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990977-NP363LP0808X
CORN.1623805163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse