MEDICARE: RILEY BRAYTON RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0003X	Inpatient Obstetric Registered Nurse	RN.1696903	CO

General Provider Information

NPI Number	:	1114803699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RILEY BRAYTON RN

Provider Business Mailing Address
First Line	:	1136 N WASHINGTON ST APT 1
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-5253
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 N WASHINGTON ST APT 1
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80203-5253
Country	:	US
Telephone Number	:	860-490-4740
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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Directions to “ RILEY BRAYTON RN” Practice Location

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