Provider Demographics
NPI:1780220111
Name:PRATHER, CAROLYN DINSDALE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:DINSDALE
Last Name:PRATHER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CAROLYN
Other - Last Name:DINSDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11750 W 2ND PL STE 150
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1724
Mailing Address - Country:US
Mailing Address - Phone:303-430-2700
Mailing Address - Fax:
Practice Address - Street 1:11750 W 2ND PL STE 150
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1724
Practice Address - Country:US
Practice Address - Phone:303-430-2700
Practice Address - Fax:303-430-2770
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012020480163W00000X
COC-APN.0001813-C-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse