Provider Demographics
NPI:1710376785
Name:THOMPSON, LAURA A (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:RACHWALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:13575 RARITAN ST
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-1036
Mailing Address - Country:US
Mailing Address - Phone:708-228-0803
Mailing Address - Fax:
Practice Address - Street 1:2535 S DOWNING ST STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5848
Practice Address - Country:US
Practice Address - Phone:720-524-1367
Practice Address - Fax:720-524-1422
Is Sole Proprietor?:No
Enumeration Date:2015-01-14
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006134363AS0400X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL085.005353OtherSTATE LICENSE