Basic Information
| Provider Information | |||||||||
| NPI: | 1336706969 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SVOBODA | ||||||||
| FirstName: | CORIE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2530 ERWIN RD APT 580 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277054775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3082894821 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8000 E MAPLEWOOD AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD VILLAGE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801114727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037854700 | ||||||||
| FaxNumber: | 3033368350 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2019 | ||||||||
| LastUpdateDate: | 03/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APN.0001737 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | 291478 | NC | N | Nursing Service Providers | Registered Nurse |
No ID Information.