Provider Demographics
NPI:1114227873
Name:HOWERTER, JOHN BERNARD (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BERNARD
Last Name:HOWERTER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 BROADWAY
Mailing Address - Street 2:UNIT 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2140
Mailing Address - Country:US
Mailing Address - Phone:720-984-7304
Mailing Address - Fax:
Practice Address - Street 1:1801 16TH ST # 800631
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5154
Practice Address - Country:US
Practice Address - Phone:970-350-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO125604367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA106116Medicare PIN