Healthcare Provider Details

I. General information

NPI: 1326413113
Provider Name (Legal Business Name): DELIVER ME JOY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2015
Last Update Date: 12/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16191 OLD FOREST PT APT 107
MONUMENT CO
80132-8689
US

IV. Provider business mailing address

16191 OLD FOREST PT APT 107
MONUMENT CO
80132-8689
US

V. Phone/Fax

Practice location:
  • Phone: 720-454-5718
  • Fax:
Mailing address:
  • Phone: 720-454-5718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMWR114
License Number StateCO

VIII. Authorized Official

Name: NEDRA HALE
Title or Position: CPM
Credential: CPM
Phone: 720-454-5718