Provider Demographics
NPI:1255753349
Name:ANGELETTI, KAITLYN N (PA-C)
Entity type:Individual
Prefix:MS
First Name:KAITLYN
Middle Name:N
Last Name:ANGELETTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9949 S OSWEGO ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3753
Mailing Address - Country:US
Mailing Address - Phone:303-925-4750
Mailing Address - Fax:303-925-4751
Practice Address - Street 1:9949 S OSWEGO ST STE 200
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3753
Practice Address - Country:US
Practice Address - Phone:303-925-4750
Practice Address - Fax:303-925-4751
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA056683363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000168502Medicaid