Provider Demographics
NPI:1598032013
Name:SAWYER, DARRAN DEE (CRNA)
Entity Type:Individual
Prefix:
First Name:DARRAN
Middle Name:DEE
Last Name:SAWYER
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 1:1338 PHAY AVE
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2302
Mailing Address - Country:US
Mailing Address - Phone:719-285-2861
Mailing Address - Fax:719-285-2101
Practice Address - Street 1:1338 PHAY AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2302
Practice Address - Country:US
Practice Address - Phone:719-285-2861
Practice Address - Fax:719-285-2101
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY615393367500000X
TX825230367500000X
AZCRNA1131367500000X
CO562367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX305565901Medicaid
TXP01095716OtherRAILROAD MEDICARE
TX8402UDOtherBCBS PIN
TXB163419Medicare PIN
AZZ179360Medicare PIN
TX339315YK6UMedicare PIN