MEDICARE: MS. MARY BETH SPINOS PNNP, CNM, MSN

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	367A00000X	Advanced Practice Midwife	87837	CO
2	363LP1700X	Perinatal Nurse Practitioner	87837	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255361341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY BETH SPINOS PNNP, CNM, MSN

Provider Business Mailing Address
First Line	:	PO BOX 800022
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64180-0022
Country	:	US
Telephone Number	:	800-953-0104
Fax Number	:	303-765-6670

Provider Business Practice Location Address
First Line	:	2030 MOUNTAIN VIEW AVE STE 400
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-3182
Country	:	US
Telephone Number	:	720-652-8730
Fax Number	:	720-652-8729

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	12/15/2021

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