Provider Demographics
NPI:1639957871
Name:WILLIAMS, ANDREA MARGARET (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARGARET
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10535 PARK MEADOWS BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8456
Mailing Address - Country:US
Mailing Address - Phone:303-662-8250
Mailing Address - Fax:303-662-8249
Practice Address - Street 1:10535 PARK MEADOWS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8456
Practice Address - Country:US
Practice Address - Phone:303-662-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant