Healthcare Provider Details

I. General information

NPI: 1295175164
Provider Name (Legal Business Name): NICOLE ELIZABETH CYR AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 HIGH STREET #110
DENVER CO
80205-5504
US

IV. Provider business mailing address

4900 SOUTH MONACO STE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-301-9019
  • Fax: 303-861-6254
Mailing address:
  • Phone: 303-301-9019
  • Fax: 303-861-6254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0000681
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number681
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: