Provider Demographics
NPI: | 1174739916 |
---|---|
Name: | GILCHRIST, NATHAN H (MS) |
Entity type: | Individual |
Prefix: | MR |
First Name: | NATHAN |
Middle Name: | H |
Last Name: | GILCHRIST |
Suffix: | |
Gender: | M |
Credentials: | MS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 8321 SANGRE DE CRISTO RD |
Mailing Address - Street 2: | STE 202 |
Mailing Address - City: | LITTLETON |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80127-6425 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-933-0017 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8321 SANGRE DE CRISTO RD |
Practice Address - Street 2: | SUITE 202 |
Practice Address - City: | LITTLETON |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80127-6425 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-984-4414 |
Practice Address - Fax: | 303-984-6244 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-05-16 |
Last Update Date: | 2010-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | AUD478 | 231H00000X |
CO | 237600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist | |
No | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | AUD478 | Other | AUDIOLOGY LIC |
CO | CO304936 | Medicare PIN |