Provider Demographics
NPI:1891703286
Name:LOPEZ RITCHIE, SHARI ELAINE (PA-C)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:ELAINE
Last Name:LOPEZ RITCHIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:ELAINE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1548 BOISE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4215
Mailing Address - Country:US
Mailing Address - Phone:307-421-4157
Mailing Address - Fax:970-669-9247
Practice Address - Street 1:1548 BOISE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4215
Practice Address - Country:US
Practice Address - Phone:970-669-9245
Practice Address - Fax:970-669-9247
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2095363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COQ54269Medicare UPIN
COQ54269Medicare UPIN