Provider Demographics
NPI:1477663607
Name:GAWRYCH, RENEE TAHENY (PNP)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:TAHENY
Last Name:GAWRYCH
Suffix:
Gender:F
Credentials:PNP
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Mailing Address - Street 1:4745 ARAPAHOE AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1080
Mailing Address - Country:US
Mailing Address - Phone:303-442-2913
Mailing Address - Fax:303-444-6198
Practice Address - Street 1:4745 ARAPAHOE AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1080
Practice Address - Country:US
Practice Address - Phone:303-442-2913
Practice Address - Fax:303-444-6198
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN0990279-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics