Provider Demographics
NPI:1447582002
Name:BACON, BARBARA J (RN)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:BACON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:SWANTEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1531 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1607
Mailing Address - Country:US
Mailing Address - Phone:303-726-7396
Mailing Address - Fax:505-368-6431
Practice Address - Street 1:1531 MARKET ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1607
Practice Address - Country:US
Practice Address - Phone:303-534-5536
Practice Address - Fax:303-534-5319
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO179169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
320059Medicare Oscar/Certification