Healthcare Provider Details

I. General information

NPI: 1912902669
Provider Name (Legal Business Name): LARAINE GUYETTE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO AT DENVER & HEALTH SCIENCES
DENVER CO
80262-0001
US

IV. Provider business mailing address

1685 UINTA ST
DENVER CO
80220-2117
US

V. Phone/Fax

Practice location:
  • Phone: 303-372-6400
  • Fax:
Mailing address:
  • Phone: 303-320-1038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number35335
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: