Healthcare Provider Details

I. General information

NPI: 1992740096
Provider Name (Legal Business Name): KARREY L TERRY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1375 E 19TH AVE
DENVER CO
80218-1114
US

IV. Provider business mailing address

15275 HANOVER CT
BRIGHTON CO
80602-5642
US

V. Phone/Fax

Practice location:
  • Phone: 303-812-2000
  • Fax:
Mailing address:
  • Phone: 720-837-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number5463
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: