Provider Demographics
NPI:1255479176
Name:BECKER, CAROLYN J (CNS)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:J
Last Name:BECKER
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:J
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2555 S DOWNING ST STE 240
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5855
Mailing Address - Country:US
Mailing Address - Phone:303-715-7030
Mailing Address - Fax:303-715-7035
Practice Address - Street 1:2555 S DOWNING ST STE 240
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5855
Practice Address - Country:US
Practice Address - Phone:303-715-7030
Practice Address - Fax:303-715-7035
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4018363L00000X
COCNS-4018364S00000X
COAPN.0004018-CNS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000144497Medicaid