Provider Demographics
NPI:1992841159
Name:ONKST, AUTUMN K (PA-C)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:K
Last Name:ONKST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11356 MESA VERDE WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-3015
Mailing Address - Country:US
Mailing Address - Phone:859-396-6162
Mailing Address - Fax:
Practice Address - Street 1:7852 S ELATI ST SUITE 101
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8079
Practice Address - Country:US
Practice Address - Phone:303-703-9151
Practice Address - Fax:303-703-9150
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA790363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY61-1427889OtherCHA
KY61-1427889OtherTRICARE
KY61-1427889OtherUHC
KYC60877OtherCUMBERLAND HEALTHCARE INC
KY000000377925OtherANTHEM
KY61-1427889OtherHUMANA
KY61-1427889OtherBLUEGRASS FAMILY HEALTH
KY95005088Medicaid
KY030670000OtherBLACK LUNG
KY50005325OtherPASSPORT HEALTH PLAN
KY61-1427889OtherBLUEGRASS FAMILY HEALTH
KY0736598Medicare PIN