Healthcare Provider Details

I. General information

NPI: 1366467631
Provider Name (Legal Business Name): BARBARA LEWIS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8381 SOUTHPARK LN
LITTLETON CO
80120-4508
US

IV. Provider business mailing address

830 FIELD ST
LAKEWOOD CO
80215-5423
US

V. Phone/Fax

Practice location:
  • Phone: 719-221-1968
  • Fax: 303-445-1837
Mailing address:
  • Phone: 719-221-1968
  • Fax: 303-445-1837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number77353
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: