Individual
MS. COLLETTE LEBA YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.0002733
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030019
KAISER COMMERCIAL NUMBER
CO
05
—
60259523
—
CO
Enumeration date
10/17/2008
Last updated
04/04/2022
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