Individual
LAURIE MARGUERITE MEDIAVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
825 E PIKES PEAK AVE, COLORADO SPRINGS, CO 80903-3624
(719) 776-8850
(719) 776-8854
Mailing address
825 E PIKES PEAK AVE, COLORADO SPRINGS, CO 80903-3624
(719) 776-8850
(719) 776-8854
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001028
CO
363AM0700X
Medical Physician Assistant
1028
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71906240
—
CO
Enumeration date
01/12/2007
Last updated
12/16/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us