Provider Demographics
NPI:1245717149
Name:POSKOCHIL, NICOLE KRISTEN (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KRISTEN
Last Name:POSKOCHIL
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 1:701 E HAMPDEN AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2759
Mailing Address - Country:US
Mailing Address - Phone:303-788-7880
Mailing Address - Fax:
Practice Address - Street 1:701 E HAMPDEN AVE STE 415
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2759
Practice Address - Country:US
Practice Address - Phone:303-788-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0005467363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant