Healthcare Provider Details

I. General information

NPI: 1821432287
Provider Name (Legal Business Name): ROBYN RYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S ALBION ST SUITE 309
DENVER CO
80222-4008
US

IV. Provider business mailing address

21189 CEDAR LAKE RD
GOLDEN CO
80401-9494
US

V. Phone/Fax

Practice location:
  • Phone: 303-300-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0196495
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: