Healthcare Provider Details

I. General information

NPI: 1245238088
Provider Name (Legal Business Name): PATRICIA W EMMONS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 E 19TH AVENUE STE 454
DENVER CO
80218-1243
US

IV. Provider business mailing address

4900 S MONACO STE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-1251
  • Fax: 303-228-1250
Mailing address:
  • Phone: 303-228-1251
  • Fax: 303-228-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number73483
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1307
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: