Provider Demographics
NPI:1093857336
Name:CASON, STACY E (CRNA)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:E
Last Name:CASON
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 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4727
Mailing Address - Country:US
Mailing Address - Phone:303-284-4220
Mailing Address - Fax:
Practice Address - Street 1:455 SHERMAN ST
Practice Address - Street 2:STE. 510
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4400
Practice Address - Country:US
Practice Address - Phone:303-377-6825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9217112367500000X
TX691865367500000X
CO184635367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO286834101Medicaid
TX8288UCOtherBLUE CROSS BLUE SHIELD
TX286834101Medicaid
TXP01046816OtherRAILROAD MEDICARE
CO286834101Medicaid
TXP01046816OtherRAILROAD MEDICARE