Provider Demographics
NPI:1851643878
Name:WESTOVER, LAURA ANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:WESTOVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S PERRY ST STE 101B
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1921
Mailing Address - Country:US
Mailing Address - Phone:303-688-2228
Mailing Address - Fax:303-353-1758
Practice Address - Street 1:1001 S PERRY ST STE 101B
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104
Practice Address - Country:US
Practice Address - Phone:303-688-2228
Practice Address - Fax:303-353-1758
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3488363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant