Healthcare Provider Details

I. General information

NPI: 1053627596
Provider Name (Legal Business Name): RICKIE DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2010
Last Update Date: 08/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10065 E HARVARD AVE STE 400
DENVER CO
80231-5943
US

IV. Provider business mailing address

10065 E HARVARD AVE STE 400
DENVER CO
80231-5943
US

V. Phone/Fax

Practice location:
  • Phone: 303-614-1400
  • Fax:
Mailing address:
  • Phone: 303-614-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number188171
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: