Provider Demographics
NPI:1891931986
Name:MCDERMOTT, PAULA ANN (CNS)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:ANN
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:MORRILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1000 SOUTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5654
Mailing Address - Country:US
Mailing Address - Phone:303-744-1065
Mailing Address - Fax:303-733-1699
Practice Address - Street 1:1000 SOUTHPARK DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5654
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89581364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89581OtherCOLORADO LICENSE