Provider Demographics
NPI:1033352513
Name:GOLD, JANICE HARKINS (PA-C)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:HARKINS
Last Name:GOLD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:303-740-5800
Mailing Address - Fax:303-740-5900
Practice Address - Street 1:8200 E BELLEVIEW AVE
Practice Address - Street 2:STE. 270E
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2803
Practice Address - Country:US
Practice Address - Phone:303-740-5800
Practice Address - Fax:303-740-5900
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO736363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50530518Medicaid
COP10292948Medicare PIN
CO50530518Medicaid