Provider Demographics
NPI:1699158477
Name:WHITSITT, LAUREN ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:WHITSITT
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 1:9399 CROWN CREST BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8508
Mailing Address - Country:US
Mailing Address - Phone:303-805-1855
Mailing Address - Fax:303-805-4421
Practice Address - Street 1:9399 CROWN CREST BLVD STE 220
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8508
Practice Address - Country:US
Practice Address - Phone:303-805-1855
Practice Address - Fax:303-805-4421
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01897363A00000X
363AS0400X
CO004298363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical