Individual provider · Type 1 NPI
Suzette Denise Vandivier, PA-C
Medical Physician Assistant · Fort Collins, CO
NPI number
1477955870
Active
Practice location
1124 E Elizabeth St
Fort Collins, CO 80524-4052
Fax (970) 482-0679
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA.0004054 (CO) |
Medical Physician Assistant: Definition to come...
Another provider at this address
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About NPI 1477955870
Suzette Denise Vandivier, PA-C's National Provider Identifier is 1477955870, issued on Sep 17, 2014. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Collins, CO. The record was last updated on Sep 17, 2014.