Provider Demographics
NPI:1427143510
Name:MASLYN, CAROL SUE (NP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:SUE
Last Name:MASLYN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5501
Mailing Address - Country:US
Mailing Address - Phone:303-934-2202
Mailing Address - Fax:303-934-1473
Practice Address - Street 1:1930 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-5501
Practice Address - Country:US
Practice Address - Phone:303-934-2202
Practice Address - Fax:303-934-1473
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55108363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO51420236Medicaid