Provider Demographics
NPI:1942515135
Name:DEVITO-HIRSCH, MEGHANN ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEGHANN
Middle Name:ANN
Last Name:DEVITO-HIRSCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGHANN
Other - Middle Name:
Other - Last Name:DEVITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2255 S ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2522
Mailing Address - Country:US
Mailing Address - Phone:303-360-6276
Mailing Address - Fax:303-467-5350
Practice Address - Street 1:700 POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6844
Practice Address - Country:US
Practice Address - Phone:303-360-6276
Practice Address - Fax:303-467-5355
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0003051363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO311342YLQPOtherMEDICARE PTAN
CO54175062Medicaid