Provider Demographics
NPI:1841715778
Name:CHAMBERS, MARY GOMEZ (DNP, CNM)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:GOMEZ
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MARGARET
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND, RN
Mailing Address - Street 1:2992 S GRAPE WAY STE A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6857
Mailing Address - Country:US
Mailing Address - Phone:303-799-7903
Mailing Address - Fax:
Practice Address - Street 1:2992 S GRAPE WAY STE A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6857
Practice Address - Country:US
Practice Address - Phone:720-295-9811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO119751163WM0102X, 163WX0003X
COAPN.0993180367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient