Provider Demographics
NPI:1588851497
Name:ALBERTY, TERI Y (CRNA)
Entity type:Individual
Prefix:MRS
First Name:TERI
Middle Name:Y
Last Name:ALBERTY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:Y
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2920 N CASCADE AVE
Mailing Address - Street 2:FL 3
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6262
Mailing Address - Country:US
Mailing Address - Phone:719-285-2434
Mailing Address - Fax:719-285-2101
Practice Address - Street 1:1338 PHAY AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2302
Practice Address - Country:US
Practice Address - Phone:719-285-2434
Practice Address - Fax:719-285-2101
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO183598367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22409033Medicaid