Provider Demographics
NPI:1003119736
Name:CRONIN, MEGAN NORA (PA)
Entity Type:Individual
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First Name:MEGAN
Middle Name:NORA
Last Name:CRONIN
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Gender:F
Credentials:PA
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-209-2503
Mailing Address - Fax:303-761-0803
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:#515
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-209-2503
Practice Address - Fax:303-761-0803
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2013-02-20
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Provider Licenses
StateLicense IDTaxonomies
CO3149363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO54984769Medicaid
NE10025942600Medicaid
KS200974510AMedicaid
KS200974510AMedicaid
COCOA104935Medicare PIN