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General NPI Number Information
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NPI Number | 1992841159
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Entity Type | Individual
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Provider Name | AUTUMN K ONKST PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 7852 S ELATI ST SUITE 101
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City | LITTLETON
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State | CO
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Zip | 80120-8079
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Country | US
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Telephone | 303-703-9151
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Fax | 303-703-9150
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Provider Business Mailing Address
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Address Line | 11356 MESA VERDE WAY
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City | PARKER
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State | CO
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Zip | 80138-3015
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Country | US
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Telephone | 859-396-6162
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA790
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License Number State | KY
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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 | PA790
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License Number State | KY
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