Provider Demographics
NPI:1922146828
Name:MCCROSKEY, DANA LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LOUISE
Last Name:MCCROSKEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MERRIMAN
Other - Last Name:MCCROSKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7951 E MAPLEWOOD AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4726
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:1700 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5405
Practice Address - Country:US
Practice Address - Phone:303-418-7600
Practice Address - Fax:303-750-3137
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1378363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69375330Medicaid
CO69375330Medicaid
COC809031Medicare PIN