Healthcare Provider Details

I. General information

NPI: 1811924079
Provider Name (Legal Business Name): CONSTANCE D GEORGE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CONSTANCE D ZERMUEHLEN CNM

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 OGDEN ST STE 320
DENVER CO
80218-3669
US

IV. Provider business mailing address

500 ELDORADO BLVD # 6250
BROOMFIELD CO
80021-3408
US

V. Phone/Fax

Practice location:
  • Phone: 303-318-2620
  • Fax: 303-318-2629
Mailing address:
  • Phone: 303-272-0751
  • Fax: 303-318-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRXM-6289
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: