Provider Demographics
NPI:1245238088
Name:EMMONS, PATRICIA W (CNM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:W
Last Name:EMMONS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO
Mailing Address - Street 2:STE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-228-1251
Mailing Address - Fax:303-228-1250
Practice Address - Street 1:1721 E 19TH AVENUE
Practice Address - Street 2:STE 454
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1243
Practice Address - Country:US
Practice Address - Phone:303-225-1251
Practice Address - Fax:303-228-1250
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO73483176B00000X
CO1307176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07734833Medicaid
COCOA102602Medicare PIN