Healthcare Provider Details

I. General information

NPI: 1932452182
Provider Name (Legal Business Name): NATHAN S HERINGHAUS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 E LOWRY BLVD STE 120
DENVER CO
80230-7195
US

IV. Provider business mailing address

8000 E MAPLEWOOD AVE STE 200
GREENWOOD VILLAGE CO
80111-4727
US

V. Phone/Fax

Practice location:
  • Phone: 303-909-4157
  • Fax:
Mailing address:
  • Phone: 419-690-7653
  • Fax: 419-697-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.13990
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0991732-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: