Provider Demographics
NPI:1841598547
Name:WEBER, RACHEL J (PA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:J
Last Name:WEBER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:CENGIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:9005 GRANT ST
Mailing Address - Street 2:STE 200
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4384
Mailing Address - Country:US
Mailing Address - Phone:303-287-2800
Mailing Address - Fax:303-287-7357
Practice Address - Street 1:9005 GRANT ST
Practice Address - Street 2:STE 200
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4300
Practice Address - Country:US
Practice Address - Phone:303-287-2800
Practice Address - Fax:303-287-7357
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA-3178363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPA-3178OtherLICENSE
COCOAAA0524OtherMEDICARE PTAN
CO12239062Medicaid