Healthcare Provider Details

I. General information

NPI: 1760099766
Provider Name (Legal Business Name): BELLA NATURAL WOMENS CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3894 OLIVE ST
DENVER CO
80207-1528
US

IV. Provider business mailing address

180 E HAMPDEN AVE STE 100
ENGLEWOOD CO
80113-2517
US

V. Phone/Fax

Practice location:
  • Phone: 303-320-8352
  • Fax:
Mailing address:
  • Phone: 303-789-4968
  • Fax: 303-789-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DENISE MARY CHISM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-789-4968