Healthcare Provider Details

I. General information

NPI: 1457276073
Provider Name (Legal Business Name): NIC SKY BRYNN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8155 E FAIRMOUNT DR UNIT 1127
DENVER CO
80230-6826
US

IV. Provider business mailing address

8155 E FAIRMOUNT DR UNIT 1127
DENVER CO
80230-6826
US

V. Phone/Fax

Practice location:
  • Phone: 720-575-6614
  • Fax:
Mailing address:
  • Phone: 720-575-6614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number1676433
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: