Healthcare Provider Details

I. General information

NPI: 1770927139
Provider Name (Legal Business Name): ERIN MOORTHY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN LEMBKE CRNA

II. Dates (important events)

Enumeration Date: 04/28/2013
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

2634 S WILLIAMS ST
DENVER CO
80210-5941
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone: 202-674-1791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN1019669
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0991812-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: