Provider Demographics
NPI:1750628079
Name:CHURCH, NOHELANI KATHERINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NOHELANI
Middle Name:KATHERINE
Last Name:CHURCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-330-0410
Mailing Address - Fax:303-330-0732
Practice Address - Street 1:24300 E SMOKY HILL RD UNIT 120
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-1387
Practice Address - Country:US
Practice Address - Phone:303-330-0410
Practice Address - Fax:303-330-0732
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0003619363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant