Provider Demographics
NPI:1023109360
Name:MONTOYA, JANICE ANDREA (PA C)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:ANDREA
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:382 S ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 48TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2712
Practice Address - Country:US
Practice Address - Phone:720-932-7714
Practice Address - Fax:720-890-0502
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO710363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical