Healthcare Provider Details

I. General information

NPI: 1114857968
Provider Name (Legal Business Name): CHARLY RYNDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH STEET 3RD FLOOR
GREELEY CO
80634-5474
US

IV. Provider business mailing address

6767 29TH STEET 3RD FLOOR
GREELEY CO
80634-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2801
  • Fax: 970-652-2827
Mailing address:
  • Phone: 970-652-2801
  • Fax: 970-652-2827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1675697
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: