Provider Demographics
NPI:1265951701
Name:BURCHAM, ELIZABETH A (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BURCHAM
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 1:9403 CROWN CREST BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-9048
Mailing Address - Country:US
Mailing Address - Phone:720-274-2544
Mailing Address - Fax:
Practice Address - Street 1:9403 CROWN CREST BLVD STE 300
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-9048
Practice Address - Country:US
Practice Address - Phone:720-274-2544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.5151363A00000X
CO193200000X207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology