Provider Demographics
NPI:1215217799
Name:MORTON, LINDSAY DANETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:DANETTE
Last Name:MORTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:DANETTE
Other - Last Name:MOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4451
Mailing Address - Fax:970-490-4199
Practice Address - Street 1:4660 YOSEMITE STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238
Practice Address - Country:US
Practice Address - Phone:720-516-8902
Practice Address - Fax:720-516-8903
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3230363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11372559Medicaid