Healthcare Provider Details

I. General information

NPI: 1003943986
Provider Name (Legal Business Name): MARJORIE E COOKE-BARTSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 E DAKOTA AVE
DENVER CO
80247-1314
US

IV. Provider business mailing address

1905 FOOTHILLS DR S
GOLDEN CO
80401-9186
US

V. Phone/Fax

Practice location:
  • Phone: 303-344-7283
  • Fax:
Mailing address:
  • Phone: 303-526-7701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number99183
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: