Provider Demographics
NPI:1013428101
Name:BUELT, MONICA (PA-C)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:BUELT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:ROSCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:850 E HARVARD AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210
Mailing Address - Country:US
Mailing Address - Phone:303-744-1961
Mailing Address - Fax:303-744-1154
Practice Address - Street 1:850 E HARVARD AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210
Practice Address - Country:US
Practice Address - Phone:303-744-1961
Practice Address - Fax:303-744-1154
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005145363A00000X
COPA.0005245363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant