Provider Demographics
NPI:1760835029
Name:SUHR, LINDSEY NICOLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:NICOLE
Last Name:SUHR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:NICOLE
Other - Last Name:GOETZMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9320 GRAND CORDERA PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-7004
Mailing Address - Country:US
Mailing Address - Phone:719-282-6337
Mailing Address - Fax:719-282-0532
Practice Address - Street 1:9320 GRAND CORDERA PKWY STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924-7004
Practice Address - Country:US
Practice Address - Phone:719-282-6337
Practice Address - Fax:719-282-0532
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004715363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant