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General NPI Number Information
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NPI Number | 1942092705
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Entity Type | Individual
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Provider Name | COREY MICHAEL BAIR FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 251 FRONT ST STE 10
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City | MONUMENT
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State | CO
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Zip | 80132-9137
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Country | US
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Telephone | 719-481-3121
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Fax |
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Provider Business Mailing Address
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Address Line | 251 FRONT ST STE 10
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City | MONUMENT
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State | CO
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Zip | 80132-9137
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Country | US
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Telephone | 719-481-3121
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RXN.0109875-NP
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License Number State | CO
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