Provider Demographics
NPI:1447214556
Name:FARRIS, SIERRA M (PA)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:M
Last Name:FARRIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:499 E HAMPDEN AVE
Mailing Address - Street 2:250
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2780
Mailing Address - Country:US
Mailing Address - Phone:303-781-0511
Mailing Address - Fax:303-781-0517
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:250
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2780
Practice Address - Country:US
Practice Address - Phone:303-781-0511
Practice Address - Fax:303-781-0517
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO0003402363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44389744Medicaid
CO44389744Medicaid
COCOA107922Medicare PIN