Provider Demographics
NPI:1710298260
Name:REDINGTON, ANA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:REDINGTON
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 1:10099 RIDGE GATE PKWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-790-1800
Mailing Address - Fax:
Practice Address - Street 1:10099 RIDGE GATE PKWY
Practice Address - Street 2:SUITE 310
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-790-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3017363AM0700X, 363AS0400X
COPA0003017363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO025882OtherKAISER COMMERCIAL NUMBER
CO78254345Medicaid