Healthcare Provider Details

I. General information

NPI: 1124571435
Provider Name (Legal Business Name): LIANN JACQUELINE WEINER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIANN JACQUELINE BORSKE PA

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7750 S BROADWAY STE 100
LITTLETON CO
80122-2630
US

IV. Provider business mailing address

7750 S BROADWAY STE 100
LITTLETON CO
80122-2630
US

V. Phone/Fax

Practice location:
  • Phone: 303-734-2090
  • Fax: 303-734-2095
Mailing address:
  • Phone: 303-734-2090
  • Fax: 303-734-2095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA.0004696
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.4696
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: