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Physician Assistants & Advanced Practice Nursing Providers Physician Assistant

Provider NPI: 1275698904

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
2635 N 7TH ST  GRAND JUNCTION, CO 81501-8209 US
Tel: 970-244-2551  Fax: --

Business Mailing Address:
DEPT 0861  DENVER, CO 80256-0001 US
Tel: 866-898-7136  Fax: 616-975-9824

NPI Information:
NPI: 1275698904
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
COPA 1669

Other Provider Identifiers:

ROCKY MTN HMO848020573009CO01

American Medical Association 2012 taxonomy code information

Code: 363A00000X





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