Liza Dylan Patrick, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

123793 Issued in CO

Practice address

3303 N. Broadway St.
Boulder, CO 80304-2241

Phone

(303) 449-6050

Fax

(303) 604-6243

NPI assigned

Mar 13, 2007

Last updated

Jul 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clinica Campesina Family Health Services

  dba Clinica Family Health

  • Clinic/Center
  • Boulder, CO
  • NPI 1184613234
  NPD (past)
• Clinica Campesina Family Health Services

  dba Clinica Family Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1790818615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 PLAZA COURT N.",
            "address_2": "#1A",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262832",
            "telephone_number": "303-665-3036",
            "fax_number": "303-604-6243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 N. BROADWAY ST.",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042241",
            "telephone_number": "303-449-6050",
            "fax_number": "303-604-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "LIZA",
        "middle_name": "DYLAN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "123793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49424882",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joli Nicol Pate, LCSW
• Deepti Patel, MD
• Kaitlin Alexis Patel
• Mira VK Patel
• Jeffrey Michael Patrician, D.D.S.
• Shannon Patrick
• Marisa Elizabeth Patt, DMD
• Alicia Patterson
• David C. Patterson, PH. D.
• Kerry Faye Patterson, RN. NP

• Advanced Practice Midwife in Boulder, CO
• Providers in Boulder, CO by specialty
• Advanced Practice Midwife in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.