Individual
DOMINICA ANNABETH HADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2101 KEN PRATT BLVD STE 104A, LONGMONT, CO 80501-6568
(303) 415-4155
(303) 776-3109
Mailing address
PO BOX 9049, BOULDER, CO 80301-9049
(303) 415-4101
(303) 415-4769
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
14612
MN
363A00000X
Physician Assistant
Primary
PA.0009638
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/23/2021
Last updated
02/27/2026
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