Provider Demographics
NPI:1316316722
Name:SUTTON, MICHAELA (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:
Other - Last Name:FELLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2230 S FRASER ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4536
Mailing Address - Country:US
Mailing Address - Phone:303-341-4200
Mailing Address - Fax:303-341-4480
Practice Address - Street 1:2230 S FRASER ST UNIT 1
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4536
Practice Address - Country:US
Practice Address - Phone:303-341-4200
Practice Address - Fax:303-341-4480
Is Sole Proprietor?:No
Enumeration Date:2015-09-16
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004337363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical