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NPI Code Detail

MEDICARE: TRICIA L SMIKAHL PA

MEDICARE: TRICIA L SMIKAHL PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2020CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386627560
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICIA L SMIKAHL PA
Provider Business Mailing Address
First Line : 2121 E HARMONY RD
Second Line : SUITE 170
City : FORT COLLINS
State : CO
Zip : 80528-3413
Country : US
Telephone Number : 970-495-7421
Fax Number : 970-493-3528
Provider Business Practice Location Address
First Line : 2121 E HARMONY RD
Second Line : SUITE 170
City : FORT COLLINS
State : CO
Zip : 80528-3413
Country : US
Telephone Number : 970-495-7421
Fax Number : 970-493-3528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 03/17/2016

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Directions to “ TRICIA L SMIKAHL PA” Practice Location

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