Healthcare Provider Details

I. General information

NPI: 1629314042
Provider Name (Legal Business Name): COURTNEY SARAH VOORUS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2012
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10835 DOVER ST STE 1100
WESTMINSTER CO
80021-5562
US

IV. Provider business mailing address

3655 E 104TH AVE
THORNTON CO
80233-4469
US

V. Phone/Fax

Practice location:
  • Phone: 303-431-5409
  • Fax: 303-431-1914
Mailing address:
  • Phone: 303-254-8500
  • Fax: 303-453-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3576
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: