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General NPI Number Information
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NPI Number | 1295374379
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Entity Type | Individual
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Provider Name | CAITLIN E O'CONNOR CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/06/2020
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Last Update Date | 04/06/2020
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Provider Practice Location Address
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Address Line | 1801 16TH ST
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City | GREELEY
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State | CO
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Zip | 80631-5154
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Country | US
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Telephone | 970-420-0905
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Fax |
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Provider Business Mailing Address
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Address Line | 2066 MAHAFFIE COURT
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City | MONUMENT
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State | CO
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Zip | 80132
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Country | US
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Telephone | 719-502-1878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0995272
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License Number State | CO
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