Provider Demographics
NPI:1083347694
Name:DIEP, EMILY (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DIEP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3095 S PARKER RD FL 2
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2924
Mailing Address - Country:US
Mailing Address - Phone:720-634-9500
Mailing Address - Fax:877-599-0808
Practice Address - Street 1:3095 S PARKER RD FL 2
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2924
Practice Address - Country:US
Practice Address - Phone:720-634-9500
Practice Address - Fax:877-599-0808
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0009221363A00000X, 363A00000X
WI7924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant