Individual
MS. SUSAN GRACE STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
2500 ROCKY MOUNTAIN AVE, SUITE 100, LOVELAND, CO 80538-9004
(970) 624-1800
(970) 624-1891
Mailing address
2500 ROCKY MOUNTAIN AVE, SUITE 100, LOVELAND, CO 80538-9004
(970) 624-1800
(970) 624-1891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002498
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134090500
—
WY
05
—
69054371
—
CO
01
—
P00757962
RR MEDICARE
CO
Enumeration date
09/25/2007
Last updated
01/09/2017
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