Healthcare Provider Details

I. General information

NPI: 1386756088
Provider Name (Legal Business Name): ANDREA B BRAY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9457 S UNIVERSITY BLVD #614
HIGHLANDS RANCH CO
80126
US

IV. Provider business mailing address

9457 S UNIVERSITY BLVD #614
HIGHLANDS RANCH CO
80126
US

V. Phone/Fax

Practice location:
  • Phone: 303-886-0668
  • Fax: 720-536-5904
Mailing address:
  • Phone: 303-886-0668
  • Fax: 720-536-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number116665
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number116665
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number116665
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: