Provider Demographics
NPI:1194305037
Name:RAGAN, EMMA BROOKS (PA-C)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:BROOKS
Last Name:RAGAN
Suffix:
Gender:
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 1:14100 E ARAPAHOE RD STE 170
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4048
Mailing Address - Country:US
Mailing Address - Phone:303-699-3190
Mailing Address - Fax:
Practice Address - Street 1:14100 E ARAPAHOE RD STE 170
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4048
Practice Address - Country:US
Practice Address - Phone:303-699-3190
Practice Address - Fax:303-699-3189
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0007455363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical