Individual
LISA CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2130 STOUT ST, DENVER, CO 80205-2827
(303) 293-2220
Mailing address
2111 CHAMPA ST, DENVER, CO 80205-2529
(303) 293-2220
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0000607
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007363
KAISER COMMERCIAL NUMBER
CO
05
—
64707229
—
CO
Enumeration date
05/29/2007
Last updated
10/04/2022
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