Healthcare Provider Details

I. General information

NPI: 1649696410
Provider Name (Legal Business Name): HEATHER NICOLE LANE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 S FRANKLIN ST
DENVER CO
80209-2608
US

IV. Provider business mailing address

333 W HAMPDEN AVE STE 600
ENGLEWOOD CO
80110-2336
US

V. Phone/Fax

Practice location:
  • Phone: 720-378-1788
  • Fax:
Mailing address:
  • Phone: 720-378-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0991099-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: