Provider Demographics
NPI:1750675476
Name:FANGROW, DAWN DENISE (CRNA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:DENISE
Last Name:FANGROW
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 1:10103 RIDGEGATE PKWY STE 312
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5525
Mailing Address - Country:US
Mailing Address - Phone:303-788-8888
Mailing Address - Fax:866-456-4594
Practice Address - Street 1:10103 RIDGEGATE PKWY STE 312
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5525
Practice Address - Country:US
Practice Address - Phone:303-788-8888
Practice Address - Fax:866-456-4594
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0101171-C-CRNA367500000X
MO2011016048367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered