Provider Demographics
NPI:1780721514
Name:GAWRON, MALGORZATA (CNS)
Entity type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:GAWRON
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 W COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3918
Mailing Address - Country:US
Mailing Address - Phone:303-432-5200
Mailing Address - Fax:303-432-5260
Practice Address - Street 1:9485 W COLFAX AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3918
Practice Address - Country:US
Practice Address - Phone:303-432-5200
Practice Address - Fax:303-432-5260
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111293363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC801815Medicare PIN
COP96073Medicare UPIN