Healthcare Provider Details

I. General information

NPI: 1548068448
Provider Name (Legal Business Name): MICHELLE CODY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 W SUMAC AVE
DENVER CO
80123-0818
US

IV. Provider business mailing address

2095 S PONTIAC WAY
DENVER CO
80224-2411
US

V. Phone/Fax

Practice location:
  • Phone: 303-601-4653
  • Fax:
Mailing address:
  • Phone: 303-389-5700
  • Fax: 303-389-5708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN-0201738
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: