Individual
LAURA FAGUNDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3825 N LAFAYETTE ST, DENVER, CO 80205-3316
(303) 500-1518
(720) 598-0440
Mailing address
1100 FEDERAL BLVD., WESTSIDE PEDIATRIC CLINIC, DENVER, CO 80204
(303) 436-4200
(303) 436-4409
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2977
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30128765
—
CO
Enumeration date
03/26/2010
Last updated
08/22/2023
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