Provider Demographics
NPI:1699731042
Name:BEYER, VICKI DEANE (CRNA)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:DEANE
Last Name:BEYER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 BELLAIRE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-388-7861
Mailing Address - Fax:
Practice Address - Street 1:300 E HAMPDEN AVE
Practice Address - Street 2:STE 202 OB GYN ANESTHESIA PC
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2654
Practice Address - Country:US
Practice Address - Phone:303-789-1940
Practice Address - Fax:303-789-2132
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3691367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90684Medicare ID - Type Unspecified