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NPI 1043009194

NPI 1043009194 : PAGE MARIE SHERRILL PA : LONGMONT, CO

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General NPI Number Information
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    NPI Number           |    1043009194
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    Entity Type          |    Individual 
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    Provider Name        |    PAGE MARIE SHERRILL PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/05/2025
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    Last Update Date     |    05/13/2025
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Provider Practice Location Address
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    Address Line         |    220 E ROGERS RD 
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    City                 |    LONGMONT
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    State                |    CO
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    Zip                  |    80501-6027
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    Country              |    US
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    Telephone            |    303-697-2583
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6237 VERNAZZA WAY UNIT 3 
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    City                 |    WINDSOR
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    State                |    CO
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    Zip                  |    80550-8454
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    Country              |    US
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    Telephone            |    763-568-1589
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    PA.0008843
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    License Number State |    CO
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