Provider Demographics
NPI:1124615356
Name:AUDET, HANNAH CAROL (PA-C)
Entity type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:CAROL
Last Name:AUDET
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 1:4185 S LIPAN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4401
Mailing Address - Country:US
Mailing Address - Phone:270-535-5461
Mailing Address - Fax:
Practice Address - Street 1:500 W 144TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9326
Practice Address - Country:US
Practice Address - Phone:720-627-4980
Practice Address - Fax:720-627-4981
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006507363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical