Provider Demographics
NPI:1700288750
Name:RUBLE, ALISON (PA-C)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:RUBLE
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 1:3520 W 92ND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3304
Mailing Address - Country:US
Mailing Address - Phone:303-429-6600
Mailing Address - Fax:720-235-4738
Practice Address - Street 1:3520 W 92ND AVE STE 104
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3304
Practice Address - Country:US
Practice Address - Phone:303-429-6600
Practice Address - Fax:720-235-4738
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0004009363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical