Provider Demographics
NPI:1346346756
Name:LEVINE, ANNA MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MICHELLE
Last Name:LEVINE
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 1:4320 W ALASKA PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-2454
Mailing Address - Country:US
Mailing Address - Phone:303-602-4660
Mailing Address - Fax:303-602-4714
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-602-4660
Practice Address - Fax:303-602-4714
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1128363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COOTH001Medicare UPIN
COCF8808Medicare ID - Type UnspecifiedMEDICARE