Provider Demographics
NPI:1831377803
Name:MCGRATH, SIRENA LIVINA (LPN)
Entity type:Individual
Prefix:MRS
First Name:SIRENA
Middle Name:LIVINA
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 S WILCOX ST SUITE 140
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104
Mailing Address - Country:US
Mailing Address - Phone:720-201-6959
Mailing Address - Fax:303-681-9949
Practice Address - Street 1:1117 FREMONT DRIVE
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CO
Practice Address - Zip Code:80118-8730
Practice Address - Country:US
Practice Address - Phone:720-201-6959
Practice Address - Fax:303-681-9949
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44470164W00000X
CAVN203060164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse