Provider Demographics
NPI:1467019364
Name:ROUSE, KESHEA DESMORNES (AGPCNP, PMHNP)
Entity type:Individual
Prefix:
First Name:KESHEA
Middle Name:DESMORNES
Last Name:ROUSE
Suffix:
Gender:
Credentials:AGPCNP, PMHNP
Other - Prefix:
Other - First Name:KESHEA
Other - Middle Name:C
Other - Last Name:DESMORNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11027 S PIKES PEAK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7361
Mailing Address - Country:US
Mailing Address - Phone:303-351-2202
Mailing Address - Fax:
Practice Address - Street 1:11027 S PIKES PEAK DR STE 105
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7361
Practice Address - Country:US
Practice Address - Phone:303-351-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-26
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.1000730-NP207QG0300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine