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NPI Code Detail

MEDICARE: HANNAH DUSTIN BRICKSE PA-C

MEDICARE: HANNAH DUSTIN BRICKSE PA-C
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.0005465CO
2363A00000XPhysician AssistantPA9108499FL

General Provider Information

NPI Number : 1558751354
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH DUSTIN BRICKSE PA-C
Provider Business Mailing Address
First Line : 4740 PEARL PKWY STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80301-3080
Country : US
Telephone Number : 303-449-2730
Fax Number : 303-449-5821
Provider Business Practice Location Address
First Line : 4740 PEARL PKWY STE 200
Second Line :
City : BOULDER
State : CO
Zip : 80301-3080
Country : US
Telephone Number : 303-449-2730
Fax Number : 303-449-5821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2015
Last Update Date : 01/22/2026

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Directions to “ HANNAH DUSTIN BRICKSE PA-C” Practice Location

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