Individual
ELIZABETH JEAN VANDERVLIET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
501 28TH ST, DENVER, CO 80205-3003
(303) 436-4133
Mailing address
501 28TH ST, DENVER, CO 80205-3003
(303) 436-4133
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2514
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2514
STATE LICENSE
CO
Enumeration date
05/19/2008
Last updated
06/15/2021
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