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NPI Code Detail

MEDICARE: TREVOR LIGHTNER PA

MEDICARE: TREVOR LIGHTNER 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 AssistantPA.0008595CO

General Provider Information

NPI Number : 1437992120
Entity Type Code : Individual
Provider Name (Legal Business Name) : TREVOR LIGHTNER PA
Provider Business Mailing Address
First Line : 3519 RICHMOND DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5995
Country : US
Telephone Number : 970-449-0951
Fax Number : 970-823-9004
Provider Business Practice Location Address
First Line : 3519 RICHMOND DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-5995
Country : US
Telephone Number : 970-449-0951
Fax Number : 970-823-9004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 01/29/2026

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Directions to “ TREVOR LIGHTNER PA” Practice Location

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