Provider Demographics
NPI:1457317174
Name:STONINGTON, JANET A (PA)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:A
Last Name:STONINGTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2995 BASELINE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2318
Mailing Address - Country:US
Mailing Address - Phone:303-443-2544
Mailing Address - Fax:303-443-6476
Practice Address - Street 1:2995 BASELINE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2318
Practice Address - Country:US
Practice Address - Phone:303-443-2544
Practice Address - Fax:303-443-6476
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO221363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69037078Medicaid
COC344828Medicare PIN
CO69037078Medicaid