Healthcare Provider Details

I. General information

NPI: 1306777669
Provider Name (Legal Business Name): LARKSPUR ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 HORIZON DR STE C
GRAND JUNCTION CO
81506-3907
US

IV. Provider business mailing address

13950 LARKSPUR DR
MONTROSE CO
81403-9387
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-8580
  • Fax:
Mailing address:
  • Phone: 970-964-9379
  • Fax: 970-236-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. CAREY SIMON
Title or Position: OWNER
Credential: CRNA
Phone: 970-964-9379