Provider Demographics
NPI:1346387511
Name:RYAN, TRACY E (CNM)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:E
Last Name:RYAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2902 ZUNI ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3827
Mailing Address - Country:US
Mailing Address - Phone:720-515-7617
Mailing Address - Fax:303-484-5458
Practice Address - Street 1:3535 S LAFAYETTE ST STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-3954
Practice Address - Country:US
Practice Address - Phone:303-788-0600
Practice Address - Fax:303-788-0602
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CORN160693367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife