Healthcare Provider Details

I. General information

NPI: 1346969870
Provider Name (Legal Business Name): SAVANNAH MARGUERITE LARSEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 ORCHARD PKWY
WESTMINSTER CO
80023-9206
US

IV. Provider business mailing address

PO BOX 738382
DALLAS TX
75373-8382
US

V. Phone/Fax

Practice location:
  • Phone: 720-627-4479
  • Fax: 720-627-3382
Mailing address:
  • Phone: 719-584-4045
  • Fax: 719-542-0809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number236529-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN.0999819-CRNA
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: