Healthcare Provider Details

I. General information

NPI: 1003480948
Provider Name (Legal Business Name): MARY MARGARET BERIGAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2021
Last Update Date: 05/15/2021
Certification Date: 05/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 DELAWARE ST
DENVER CO
80204-4532
US

IV. Provider business mailing address

2967 S ZENOBIA ST
DENVER CO
80236-2030
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-6000
  • Fax:
Mailing address:
  • Phone: 402-880-3705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number0996310
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: