Healthcare Provider Details

I. General information

NPI: 1033428941
Provider Name (Legal Business Name): CAREY B SIMON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E 3RD ST
DELTA CO
81416-2815
US

IV. Provider business mailing address

13950 LARKSPUR DR
MONTROSE CO
81403-9387
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-2255
  • Fax:
Mailing address:
  • Phone: 720-939-5138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0991673-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: