Provider Demographics
NPI:1396784260
Name:BRYANT, CHRISTIE G (CNM)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:G
Last Name:BRYANT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-320-2711
Mailing Address - Fax:303-433-7051
Practice Address - Street 1:4650 W 38TH AVE
Practice Address - Street 2:STE 215
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-2161
Practice Address - Country:US
Practice Address - Phone:303-320-2711
Practice Address - Fax:303-433-7051
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO90928367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07909286Medicaid
Q10470Medicare UPIN
COCOA107174Medicare UPIN
CO07909286Medicaid