Individual
MS. ANNA T ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4743 ARAPAHOE AVE, SUITE 201, BOULDER, CO 80303-1113
(303) 442-2395
(303) 442-1073
Mailing address
5450 WESTERN AVE, SUITE B, BOULDER, CO 80301-2709
(303) 442-2395
(303) 442-1073
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
878
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07008782
—
CO
Enumeration date
06/23/2005
Last updated
11/10/2017
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