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General NPI Number Information
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NPI Number | 1477219046
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Entity Type | Individual
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Provider Name | RYLEE GEORGINE BENNETT PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4507
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Country | US
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Telephone | 303-436-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1352 N DOWNING ST
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City | DENVER
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State | CO
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Zip | 80218-2176
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Country | US
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Telephone | 850-276-5096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0007326
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License Number State | CO
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