Provider Demographics
NPI:1679898621
Name:BRAY SURGICAL ASSISTING, INC
Entity Type:Organization
Organization Name:BRAY SURGICAL ASSISTING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:303-886-0668
Mailing Address - Street 1:9457 S UNIVERSITY BLVD
Mailing Address - Street 2:614
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4976
Mailing Address - Country:US
Mailing Address - Phone:303-886-0668
Mailing Address - Fax:
Practice Address - Street 1:9457 S UNIVERSITY BLVD
Practice Address - Street 2:614
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-4976
Practice Address - Country:US
Practice Address - Phone:303-886-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO116665163WR0006X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty