Provider Demographics
NPI:1255323846
Name:SCHARFF, KEVIN DALE (CRNA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DALE
Last Name:SCHARFF
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 1:118 HILLSIDE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-7001
Mailing Address - Country:US
Mailing Address - Phone:970-580-9003
Mailing Address - Fax:
Practice Address - Street 1:1397 WEIMER RD
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6253
Practice Address - Country:US
Practice Address - Phone:970-580-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCRNA - 01154367500000X
COCRA100022367500000X
IAD-127437367500000X
KY3009206367500000X
NE101178367500000X
NVCRNA000411367500000X
NDR28328367500000X
OR201403005CRNA367500000X
TXAP109560367500000X
WY30290.1156367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered