Provider Demographics
NPI:1164411906
Name:MERRILL-HALL, MARTHA E (CNM)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:E
Last Name:MERRILL-HALL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Mailing Address - Street 1:500 ELDORADO BLVD
Mailing Address - Street 2:SUITE 6250
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3408
Mailing Address - Country:US
Mailing Address - Phone:303-272-0751
Mailing Address - Fax:303-318-2488
Practice Address - Street 1:1960 OGDEN ST
Practice Address - Street 2:SUITE320
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3666
Practice Address - Country:US
Practice Address - Phone:303-318-2620
Practice Address - Fax:303-318-2629
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2020-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA235953367A00000X
CO51684367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7516842Medicaid
CO7516842Medicaid