Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 88068 | CO |
NPI | 1043308778 |
---|---|
Provider Name | Deborah L Crennen |
First Address | Denver, CO 80231-4630 |
Second Address | Commerce City, CO 80022-2343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 06/04/2021 |