Healthcare Provider Details

I. General information

NPI: 1316224603
Provider Name (Legal Business Name): LORI A DENEWILER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2011
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9815 N 95TH ST
SCOTTSDALE AZ
85258-4546
US

IV. Provider business mailing address

17505 N 79TH AVE STE 304E
GLENDALE AZ
85308-8729
US

V. Phone/Fax

Practice location:
  • Phone: 480-407-6400
  • Fax: 480-407-6400
Mailing address:
  • Phone: 480-407-6400
  • Fax: 480-407-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number619236
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA0864
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: