Healthcare Provider Details

I. General information

NPI: 1447793104
Provider Name (Legal Business Name): NATALIE R BACA CPM, RM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N WILLIAMS ST # 203
DENVER CO
80218-2515
US

IV. Provider business mailing address

1400 N WILLIAMS ST # 203
DENVER CO
80218-2515
US

V. Phone/Fax

Practice location:
  • Phone: 720-343-9959
  • Fax: 720-909-8020
Mailing address:
  • Phone: 720-343-9959
  • Fax: 720-909-8020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMWR.0000178
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: