Provider Demographics
NPI:1154673408
Name:SUTTER, ADRIAN ERICA (PA-C)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:ERICA
Last Name:SUTTER
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 1:6950 E BELLEVIEW AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1629
Mailing Address - Country:US
Mailing Address - Phone:480-894-2823
Mailing Address - Fax:480-756-6663
Practice Address - Street 1:5030 S MILL AVE
Practice Address - Street 2:SUITE D12
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6833
Practice Address - Country:US
Practice Address - Phone:480-894-2823
Practice Address - Fax:480-756-6663
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004084363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant