Provider Demographics
NPI:1699834861
Name:ALLDERDICE, PAULA ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:ALLDERDICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6162 S. WILLOW DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5114
Mailing Address - Country:US
Mailing Address - Phone:303-220-9200
Mailing Address - Fax:303-220-9208
Practice Address - Street 1:7000 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1617
Practice Address - Country:US
Practice Address - Phone:303-663-7650
Practice Address - Fax:303-688-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO90882163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07908825Medicaid