Healthcare Provider Details

I. General information

NPI: 1356870554
Provider Name (Legal Business Name): CHYNNA PHILLIPS FRANA AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2017
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 BRIARGATE BLVD STE D
COLORADO SPRINGS CO
80920-3417
US

IV. Provider business mailing address

90 MADISON ST STE 201
DENVER CO
80206-3417
US

V. Phone/Fax

Practice location:
  • Phone: 719-388-1404
  • Fax:
Mailing address:
  • Phone: 719-388-1404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0000850
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0000850
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: