Healthcare Provider Details

I. General information

NPI: 1184047334
Provider Name (Legal Business Name): ELIZABETH D. DASHER, SA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7038 HONEYCOMB DR
PEYTON CO
80831-5041
US

IV. Provider business mailing address

7038 HONEYCOMB DR
PEYTON CO
80831-5041
US

V. Phone/Fax

Practice location:
  • Phone: 970-371-6277
  • Fax:
Mailing address:
  • Phone: 970-371-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. ELIZABETH D DASHER
Title or Position: PRESIDENT
Credential: LSA
Phone: 970-371-6277