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Individual

NICOLE M VANICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(720) 321-1048
Mailing address
PO BOX 150, HOLLY, CO 81047-0150
(719) 537-0712
(719) 537-6284

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
175866
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
202862
CO

Other

Enumeration date
12/29/2011
Last updated
04/05/2024
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