Provider Demographics
NPI:1497177794
Name:ALBERT, MARCY C (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:C
Last Name:ALBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:
Other - Last Name:ROHRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11245 HURON ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2806
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:11245 HURON ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2806
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3825363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO024475OtherKAISER COMMERCIAL NUMBER
CO07070853Medicaid
CO347693YK5YMedicare PIN