Healthcare Provider Details

I. General information

NPI: 1003801242
Provider Name (Legal Business Name): HEATHER ANN NEWMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER ANN LEMBO CRNA

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

IV. Provider business mailing address

1650 COCHRANE CIR
FORT CARSON CO
80913-4613
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-7943
  • Fax:
Mailing address:
  • Phone: 719-526-7943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP 9228539
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1093
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.1000700-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: