MEDICARE: MS. BARBARA J. BACON 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	163W00000X	Registered Nurse	179169	CO

General Provider Information

NPI Number	:	1447582002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA J. BACON RN

Provider Business Mailing Address
First Line	:	1531 MARKET ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-1607
Country	:	US
Telephone Number	:	303-726-7396
Fax Number	:	505-368-6431

Provider Business Practice Location Address
First Line	:	1531 MARKET ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80202-1607
Country	:	US
Telephone Number	:	303-534-5536
Fax Number	:	303-534-5319

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

Provider Enumeration Date	:	02/08/2010
Last Update Date	:	03/05/2020

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