Provider Demographics
NPI:1235702069
Name:SKRZELOWSKI, DAVID MARK (SRNA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MARK
Last Name:SKRZELOWSKI
Suffix:
Gender:M
Credentials:SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 840862
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0862
Mailing Address - Country:US
Mailing Address - Phone:303-377-7638
Mailing Address - Fax:303-780-0787
Practice Address - Street 1:8000 E MAPLEWOOD AVE STE 120
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4766
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:972-043-9950
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT180095163W00000X
COAPN.1000212-CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse