Provider Demographics
NPI:1801822358
Name:PERCEFULL, ANNETTE ELLEN (ANP)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:ELLEN
Last Name:PERCEFULL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MRS
Other - First Name:ANNETTE
Other - Middle Name:ELLEN
Other - Last Name:HULTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2550 S. UNIVERSITY BLVD #901
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:303-885-9152
Mailing Address - Fax:
Practice Address - Street 1:2434 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-7532
Practice Address - Country:US
Practice Address - Phone:303-885-9152
Practice Address - Fax:303-447-2882
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60887363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner