Individual
MR. DERICK EVERETT BEISWANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
Mailing address
1236 E ELIZABETH ST, SUITE 1, FORT COLLINS, CO 80524-4000
(970) 224-2985
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN.0188164
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137157600
—
WY
05
—
94500371
—
CO
01
—
P01332494
RR MEDICARE
CO
Enumeration date
03/25/2014
Last updated
01/20/2015
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