Provider Demographics
NPI:1891041810
Name:BAXTER, VALORIE ANNE (PA)
Entity Type:Individual
Prefix:
First Name:VALORIE
Middle Name:ANNE
Last Name:BAXTER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 STEELE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4479
Mailing Address - Country:US
Mailing Address - Phone:303-372-4000
Mailing Address - Fax:303-372-4001
Practice Address - Street 1:311 STEELE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4479
Practice Address - Country:US
Practice Address - Phone:303-372-4000
Practice Address - Fax:303-372-4001
Is Sole Proprietor?:No
Enumeration Date:2012-07-27
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004907363A00000X
VA0110006960363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000141976Medicaid
CO9000141976Medicaid