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General NPI Number Information
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NPI Number | 1861708042
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Entity Type | Individual
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Provider Name | TERRI RENEE NOLAND CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2545
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 12401 E 17TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2548
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Country | US
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Telephone | 720-848-6745
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 699211
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COMPACT - 699211
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License Number State | TX
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