Provider Demographics
NPI:1659771475
Name:TRIMBATH, BRITTANY LIVELY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:LIVELY
Last Name:TRIMBATH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:BRITTANY
Other - Middle Name:PAGE
Other - Last Name:LIVELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8354 E NORTHFIELD BLVD STE 3700
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3131
Mailing Address - Country:US
Mailing Address - Phone:303-390-0208
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:8354 E NORTHFIELD BLVD STE 3700
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3131
Practice Address - Country:US
Practice Address - Phone:303-390-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-28
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004046363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO48606022Medicaid
CO48606022Medicaid