MEDICARE: JOSETY MELISSA LARA HERNANDEZ

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	374J00000X	Doula

General Provider Information

NPI Number	:	1396609038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSETY MELISSA LARA HERNANDEZ

Provider Business Mailing Address
First Line	:	7505 W YALE AVE UNIT 2402
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80227-3405
Country	:	US
Telephone Number	:	720-295-8491
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 W YALE AVE UNIT 2402
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80227-3405
Country	:	US
Telephone Number	:	720-295-8491
Fax Number	:

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

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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