Individual
CODY LEE BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
12167 SHERIDAN BLVD, BROOMFIELD, CO 80020-2417
(303) 658-9807
Mailing address
4371 W 118TH PL STE 5510, WESTMINSTER, CO 80031-5041
(720) 951-2072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0994785
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598319642
—
UT
Enumeration date
07/26/2019
Last updated
01/27/2024
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