1124546734 NPI number — GLENDA IRENE BEYERS RN

Table of content: GLENDA IRENE BEYERS RN (NPI 1124546734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124546734 NPI number — GLENDA IRENE BEYERS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEYERS
Provider First Name:
GLENDA
Provider Middle Name:
IRENE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FLYNN
Provider Other First Name:
GLENDA
Provider Other Middle Name:
IRENE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124546734
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10187 WACO ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COMMERCE CITY
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-248-3288
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8300 W. 38TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEAT RIDGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-425-4500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WX0003X , with the licence number:  0170468 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)