Provider Demographics
NPI:1447793104
Name:BACA, NATALIE R (CPM, RM)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:BACA
Suffix:
Gender:F
Credentials:CPM, RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N WILLIAMS ST # 203
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2515
Mailing Address - Country:US
Mailing Address - Phone:720-343-9959
Mailing Address - Fax:720-909-8020
Practice Address - Street 1:1400 N WILLIAMS ST # 203
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2515
Practice Address - Country:US
Practice Address - Phone:720-343-9959
Practice Address - Fax:720-909-8020
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMWR.0000178176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife