Provider Demographics
NPI:1275182628
Name:HERBERT, MEREDITH ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ANN
Last Name:HERBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:18890 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-3504
Mailing Address - Country:US
Mailing Address - Phone:303-617-1604
Mailing Address - Fax:303-617-3539
Practice Address - Street 1:18890 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3504
Practice Address - Country:US
Practice Address - Phone:303-617-1604
Practice Address - Fax:303-617-3539
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005902363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant