Individual
MADELINE ELAINE LUTTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(303) 493-7000
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
APA2185
OK
363A00000X
Physician Assistant
PA.0005252
CO
363A00000X
Physician Assistant
PA9107907
FL
363AM0700X
Medical Physician Assistant
Primary
PA.0005252
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003155283A
—
GA
05
—
013841400
—
FL
05
—
200478630A
—
OK
Enumeration date
01/21/2013
Last updated
10/13/2021
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