Provider Demographics
NPI:1356321590
Name:PERDUE, DALENE D (CRNA)
Entity Type:Individual
Prefix:
First Name:DALENE
Middle Name:D
Last Name:PERDUE
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 1:3000 S JAMAICA CT STE 140
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4601
Mailing Address - Country:US
Mailing Address - Phone:303-755-3201
Mailing Address - Fax:303-755-3204
Practice Address - Street 1:3000 S JAMAICA CT STE 140
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4601
Practice Address - Country:US
Practice Address - Phone:303-755-3201
Practice Address - Fax:303-755-3204
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO150270367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYP00465632OtherMEDICARE RAILROAD
WYP00465632OtherMEDICARE RAILROAD