Individual
MRS. SUSAN LYNN RANCIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3434 47TH STREET, #200, BOULDER, CO 80301-1880
(303) 444-8100
(303) 444-8113
Mailing address
3434 47TH STREET, #200, BOULDER, CO 80301-1880
(303) 444-8100
(303) 444-8113
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
179
CO
363AM0700X
Medical Physician Assistant
179
CO
363AS0400X
Surgical Physician Assistant
179
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34524037
—
CO
Enumeration date
08/30/2005
Last updated
05/28/2010
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