Provider Demographics
NPI:1669181384
Name:PERSEVERE HEALTHCARE
Entity type:Organization
Organization Name:PERSEVERE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FNP/COACH
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, NHA
Authorized Official - Phone:414-788-0008
Mailing Address - Street 1:3912 RIVIERA GRV APT 204
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3365
Mailing Address - Country:US
Mailing Address - Phone:414-788-0008
Mailing Address - Fax:
Practice Address - Street 1:6475 WALL ST # 130
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8337
Practice Address - Country:US
Practice Address - Phone:414-841-9959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty