Provider Demographics
NPI:1780910877
Name:PLEUNE, ANDREA YVONNE (PA-C, MS)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:YVONNE
Last Name:PLEUNE
Suffix:
Gender:F
Credentials:PA-C, MS
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:YVONNE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MS
Mailing Address - Street 1:10350 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1314
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:311 STEELE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4479
Practice Address - Country:US
Practice Address - Phone:303-372-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-23
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0002909363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPAL-2909OtherCOLORADO STATE LICENSE
CO028628OtherKAISER COMMERCIAL
CO9000153469Medicaid
CO1089095OtherNCCPA BOARD CERTIFIED