Provider Demographics
NPI:1750150330
Name:MULUNEH, BELSTI YESHEALEM (PMHNP STUDENT)
Entity type:Individual
Prefix:
First Name:BELSTI
Middle Name:YESHEALEM
Last Name:MULUNEH
Suffix:
Gender:M
Credentials:PMHNP STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23501 E PORTLAND WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-2436
Mailing Address - Country:US
Mailing Address - Phone:713-324-6515
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO390200000X
CO1656734363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program