=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841789807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHLOE BANNING PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2018
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1021 LINCOLN AVE
-----------------------------------------------------
City | STEAMBOAT SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80487-5271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-439-0091
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1815 CENTRAL PARK DR STE 110 PMB 131
-----------------------------------------------------
City | STEAMBOAT SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80487
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-439-0091
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------