Provider Demographics
NPI:1285977017
Name:WHITESCARVER, ANNETTE LAURA (PA-C)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:LAURA
Last Name:WHITESCARVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:LAURA
Other - Last Name:SCHIEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6169 S BALSAM WAY
Mailing Address - Street 2:SUITE # 250
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3062
Mailing Address - Country:US
Mailing Address - Phone:303-933-4555
Mailing Address - Fax:
Practice Address - Street 1:6169 S BALSAM WAY
Practice Address - Street 2:SUITE # 250
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3062
Practice Address - Country:US
Practice Address - Phone:303-933-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3509363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant