Provider Demographics
NPI:1538400973
Name:GEISLER, GRANT STEPHAN (CRNA)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:STEPHAN
Last Name:GEISLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4766
Mailing Address - Country:US
Mailing Address - Phone:303-785-4700
Mailing Address - Fax:303-336-8350
Practice Address - Street 1:8000 E MAPLEWOOD AVE
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:303-785-4700
Practice Address - Fax:303-336-8350
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY680095207L00000X
FLARNP9270689367500000X
COAPN.0993822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008422100Medicaid
GA003132455AMedicaid
FLHF709ZMedicare PIN