Provider Demographics
NPI:1215126982
Name:MAHARJAN, KARLA LEA
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:LEA
Last Name:MAHARJAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:L
Other - Last Name:MAHARJAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:2535 S DOWNING ST
Mailing Address - Street 2:SUITE 480
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5847
Mailing Address - Country:US
Mailing Address - Phone:303-493-5200
Mailing Address - Fax:720-570-2012
Practice Address - Street 1:2535 S DOWNING ST
Practice Address - Street 2:SUITE 480
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5847
Practice Address - Country:US
Practice Address - Phone:303-493-5200
Practice Address - Fax:720-570-2012
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2522363AM0700X
COPA.0002522363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37156039OtherMEDICAID GROUP NUMBER
COC495158OtherMEDICARE GROUP NUMBER
CO45959811Medicaid
COCOA107128Medicare PIN
COC811385Medicare PIN