Healthcare Provider Details
I. General information
NPI: 1215126982
Provider Name (Legal Business Name): KARLA LEA MAHARJAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/18/2007
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2535 S DOWNING ST SUITE 480
DENVER CO
80210-5847
US
IV. Provider business mailing address
2535 S DOWNING ST SUITE 480
DENVER CO
80210-5847
US
V. Phone/Fax
- Phone: 303-493-5200
- Fax: 720-570-2012
- Phone: 303-493-5200
- Fax: 720-570-2012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 2522 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA.0002522 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: