Provider Demographics
NPI:1891494704
Name:WILSON, ANNA LEE (PA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LEE
Last Name:WILSON
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:4350 LIMELIGHT AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-8034
Mailing Address - Country:US
Mailing Address - Phone:720-686-7546
Mailing Address - Fax:720-686-7544
Practice Address - Street 1:9397 CROWN CREST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8788
Practice Address - Country:US
Practice Address - Phone:720-686-7546
Practice Address - Fax:720-686-7544
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-11-14
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Provider Licenses
StateLicense IDTaxonomies
COPA.0007679363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical