Provider Demographics
NPI:1083034979
Name:CREPEAU, MARIA GLASIA
Entity Type:Individual
Prefix:
First Name:MARIA GLASIA
Middle Name:
Last Name:CREPEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19858 E PRENTICE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3772
Mailing Address - Country:US
Mailing Address - Phone:253-590-6712
Mailing Address - Fax:
Practice Address - Street 1:8401 S CHAMBERS RD STE H-101
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9498
Practice Address - Country:US
Practice Address - Phone:720-875-2876
Practice Address - Fax:720-875-2877
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program