Provider Demographics
NPI:1306850581
Name:BETHEL, ANN MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:BETHEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:MACPHERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:455 SHERMAN STREET
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203
Mailing Address - Country:US
Mailing Address - Phone:303-744-8644
Mailing Address - Fax:303-997-2116
Practice Address - Street 1:455 SHERMAN STREET
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203
Practice Address - Country:US
Practice Address - Phone:303-744-8644
Practice Address - Fax:303-997-2116
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2119242367500000X
CO183619367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27188523Medicaid
FL303746100Medicaid
CO27188523Medicaid
FLG1664XMedicare PIN