Individual
LISA ANN NYDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1001 SOUTHPARK DR, LITTLETON, CO 80120-5641
(303) 722-8789
(303) 722-2935
Mailing address
7305 S PLATTE RIVER PKWY, LITTLETON, CO 80120-2911
(925) 830-8485
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3217
CA
367500000X
Certified Registered Nurse Anesthetist
APN.0991047-CRNA
CO
Other
Enumeration date
01/10/2007
Last updated
05/08/2015
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