Provider Demographics
NPI:1366467631
Name:LEWIS, BARBARA (CRNA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LEWIS
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 1:830 FIELD ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5423
Mailing Address - Country:US
Mailing Address - Phone:719-221-1968
Mailing Address - Fax:303-445-1837
Practice Address - Street 1:8381 SOUTHPARK LN
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4508
Practice Address - Country:US
Practice Address - Phone:719-221-1968
Practice Address - Fax:303-445-1837
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO77353367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07773534Medicaid
CO07773534Medicaid