Healthcare Provider Details

I. General information

NPI: 1073119186
Provider Name (Legal Business Name): RACHAEL L NEWNAM CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2020
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 W 2ND PL
LAKEWOOD CO
80228-1527
US

IV. Provider business mailing address

2403 N RACE ST
DENVER CO
80205-5643
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.0192293
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0996237-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: