Provider Demographics
NPI:1396361986
Name:GAUMOND, ANGELA MICHELLE (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MICHELLE
Last Name:GAUMOND
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:GAUMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN APN, PMHNP-BC
Mailing Address - Street 1:753 MALETA LANE, SUITE 204
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108
Mailing Address - Country:US
Mailing Address - Phone:303-993-6071
Mailing Address - Fax:
Practice Address - Street 1:753 MALETA LANE, SUITE 204
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:303-993-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997992-NP363LP0808X
CO19720020872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1972002087Medicaid