Healthcare Provider Details

I. General information

NPI: 1942246657
Provider Name (Legal Business Name): CHRISTOPHER C. WINCKLER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 12/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4507
US

IV. Provider business mailing address

2716 YORK ST
DENVER CO
80205-4661
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-8375
  • Fax: 303-436-6548
Mailing address:
  • Phone: 303-957-8128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2912
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number5014
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: