Bacon, Nicki A

Bacon, Nicki A is an individual health care provider with primary practice located at 3555 Lutheran Parkway Suite 200, Wheat Ridge CO 80033-6018. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bacon, Nicki A can be contacted via phone (720) 284-3700.

Contact Information

Primary practice address
3555 Lutheran Parkway Suite 200 Wheat Ridge CO 80033-6018
Phone: (720) 284-3700
Fax: (303) 467-0525
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 36690 Colorado

Profile Details

NPI number 1801815691
LBN Legal business name Bacon, Nicki A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated May 30th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801815691 NPPES
Colorado MEDICAID 17206359

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