Basic Information
| Provider Information | |||||||||
| NPI: | 1073756896 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAYNHAM | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | HARRISE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CERTIFIED FAMILY NUR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 ELDORADO BLVD STE 6250 | ||||||||
| Address2: | |||||||||
| City: | BROOMFIELD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800213421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3032720768 | ||||||||
| FaxNumber: | 3033182488 | ||||||||
| Practice Location | |||||||||
| Address1: | 3210 LUTHERAN PKWY | ||||||||
| Address2: | |||||||||
| City: | WHEAT RIDGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800336019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034258000 | ||||||||
| FaxNumber: | 3034674925 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2009 | ||||||||
| LastUpdateDate: | 12/18/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | #93440 RXN-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.