Provider Demographics
NPI:1770927139
Name:MOORTHY, ERIN (CRNA)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MOORTHY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:LEMBKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2634 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5941
Mailing Address - Country:US
Mailing Address - Phone:202-674-1791
Mailing Address - Fax:
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-28
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1019669367500000X
COAPN.0991812-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered