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 1:6055 W 46TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-1812
Mailing Address - Country:US
Mailing Address - Phone:303-423-8017
Mailing Address - Fax:
Practice Address - Street 1:6055 W 46TH AVE STE A
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-1812
Practice Address - Country:US
Practice Address - Phone:303-423-8017
Practice Address - Fax:720-639-6894
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2024-08-15
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