Provider Demographics
NPI:1346638020
Name:MOLES, ANNA LISABETH (PA)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:LISABETH
Last Name:MOLES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:LISABETH
Other - Last Name:CHRISTENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 S PERRY ST
Mailing Address - Street 2:STE. 101B
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2668
Mailing Address - Country:US
Mailing Address - Phone:303-688-2228
Mailing Address - Fax:303-663-0640
Practice Address - Street 1:1001 S PERRY ST
Practice Address - Street 2:STE. 101B
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2668
Practice Address - Country:US
Practice Address - Phone:303-688-2228
Practice Address - Fax:303-663-0640
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004169363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant