CANON PROFESSIONAL WELLNESS CLINIC LLC
NPI 1780384560
Nurse Practitioner - Primary Care in Canon City, CO

Active since March 09, 2023
730 MACON AVE, CANON CITY, CO 81212(719) 275-1618 Get Directions Write a Review

NPPES record last updated: February 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 25, 2023, Mar 9, 2023 (2 updates tracked since 2023).

About Canon Professional Wellness Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANON PROFESSIONAL WELLNESS CLINIC LLC (NPI 1780384560) is a healthcare organization registered as a primary care in Canon City, Colorado and active in the NPI registry since March 2023. The organization lists Leslie Nelson, Owner, as its authorized official.

NPPES Registry Identity

NPI1780384560
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameCANON PROFESSIONAL WELLNESS CLINIC LLC
Location Address730 MACON AVECanon City, CO 81212-3314
Mailing Address730 Macon AveCanon City, CO 81212-3314 · (719) 275-1618
Organization SubpartNo
Authorized OfficialLeslie NelsonOwner · (719) 285-5019
Enumeration DateMarch 9, 2023
Last NPPES UpdateFebruary 19, 20242 updates tracked since enumeration
NPPES CertifiedFebruary 19, 2024
NPI 1780384560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
730 MACON AVE, Canon City, CO 81212

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
730 MACON AVE
CANON CITY, CO 81212
Clinic/Center (Primary Care)
730 MACON AVE
CANON CITY, CO 81212
Family Medicine
730 MACON AVE
CANON CITY, CO 81212
Nurse Practitioner (Family)
730 MACON AVE
CANON CITY, CO 81212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Canon Professional Wellness Clinic LLC's NPI number?

The NPI number for Canon Professional Wellness Clinic LLC is 1780384560. It was assigned to this organization in the NPPES registry on March 9, 2023.

Where is Canon Professional Wellness Clinic LLC located?

Canon Professional Wellness Clinic LLC is located at 730 Macon Ave, Canon City, CO 81212. The listed phone number is (719) 275-1618.

What is Canon Professional Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Canon Professional Wellness Clinic LLC was last updated on February 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.