Healthcare Provider Details

I. General information

NPI: 1518389063
Provider Name (Legal Business Name): BRITTANY GANSAR MCCARTY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS BRITTANY LAUREN GANSAR

II. Dates (important events)

Enumeration Date: 01/16/2014
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 E KEN PRATT BLVD STE 205
LONGMONT CO
80504-5311
US

IV. Provider business mailing address

2500 ROCKY MOUNTAIN AVE NMOB SUITE 2200
LOVELAND CO
80538
US

V. Phone/Fax

Practice location:
  • Phone: 720-718-3930
  • Fax: 720-718-0939
Mailing address:
  • Phone: 970-203-7250
  • Fax: 970-203-7256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0003898
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0003898
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: