Provider Demographics
NPI:1003075821
Name:HILLARY, LAUREN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:HILLARY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ELIZABETH
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5200 DTC PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2719
Mailing Address - Country:US
Mailing Address - Phone:303-745-0000
Mailing Address - Fax:303-708-1834
Practice Address - Street 1:5200 DTC PKWY
Practice Address - Street 2:SUITE 400
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2719
Practice Address - Country:US
Practice Address - Phone:303-745-0000
Practice Address - Fax:303-708-1834
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0002608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO75478056Medicaid
COCO301309Medicare PIN