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NPI Code Detail

MEDICARE: SUZANNE DIXON GRADY CNM, RN

MEDICARE: SUZANNE DIXON GRADY CNM, RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife168897CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275613077
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE DIXON GRADY CNM, RN
Provider Business Mailing Address
First Line : 3701 S BROADWAY
Second Line :
City : ENGLEWOOD
State : CO
Zip : 80113-3611
Country : US
Telephone Number : 303-360-6276
Fax Number :
Provider Business Practice Location Address
First Line : 3292 PEORIA ST
Second Line :
City : AURORA
State : CO
Zip : 80010-1517
Country : US
Telephone Number : 303-360-6276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 03/09/2016

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