Individual
MR. DARREL LEE VANIWARDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1817 FLORA CT, CANON CITY, CO 81212-4576
(719) 275-0549
Mailing address
1817 FLORA CT, CANON CITY, CO 81212-4576
(719) 275-0549
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
58295
CO
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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