Provider Demographics
NPI:1932622719
Name:ALBERT, BROOKE ANNETTE (PA-C)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANNETTE
Last Name:ALBERT
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 1:2801 YOUNGFIELD ST STE 150
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-0209
Mailing Address - Country:US
Mailing Address - Phone:303-238-4277
Mailing Address - Fax:303-238-4977
Practice Address - Street 1:2801 YOUNGFIELD ST STE 150
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-0209
Practice Address - Country:US
Practice Address - Phone:303-238-4277
Practice Address - Fax:303-238-4977
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005031363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPA.0005031OtherDORA