Provider Demographics
NPI:1083358212
Name:DOROSARIO, FRANCES
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:DOROSARIO
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 1:1122 N CLARK ST APT 1706
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7879
Mailing Address - Country:US
Mailing Address - Phone:610-731-9155
Mailing Address - Fax:
Practice Address - Street 1:3702 AUTOMATION WAY STE 103
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5738
Practice Address - Country:US
Practice Address - Phone:970-922-3630
Practice Address - Fax:970-223-1118
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1680045163W00000X
COAPN.0997676-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse