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General NPI Number Information
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NPI Number | 1437450996
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Entity Type | Individual
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Provider Name | LORIE ANN AUSTIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/15/2010
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 1750 E KEN PRATT BLVD
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City | LONGMONT
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State | CO
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Zip | 80504-5311
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Country | US
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Telephone | 720-718-3900
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Fax | 720-718-0999
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Provider Business Mailing Address
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Address Line | 1750 E KEN PRATT BLVD
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City | LONGMONT
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State | CO
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Zip | 80504-5311
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Country | US
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Telephone | 720-718-3900
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Fax | 720-718-0999
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.0004954
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9105670
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0004954
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License Number State | CO
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