Provider Demographics
NPI:1326343682
Name:SUTTER, MICHELLE E (PNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:SUTTER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH
Other - Last Name:BEHNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-6132
Practice Address - Fax:720-777-7341
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO990076363LP0200X
CO177951163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49406060Medicaid
CO49406060Medicaid