SUSAN PUCKETT (NPI# 1972588358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972588358 |
| Entity Type | Individual |
| Full Name | SUSAN PUCKETT |
| Credential | P.A. |
| Practice Address |
2750 Broadway St Boulder CO 80304-3573 |
| Practice Telephone | 3034403000 |
| Mailing Telephone | 3034403000 |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
954 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093218083 | Susan Kay Puckett | Registered Nurse | 320 W 24th St, Kearney, NE 68845-5331 | 2018-03-15 |
| Street Address |
2750 BROADWAY ST |
| City | BOULDER |
| State | CO |
| Zip Code | 80304-3573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275537078 | Emma E.k. Mccarty | Internal Medicine | 2750 Broadway St, Boulder, CO 80304-3573 | 2005-06-09 |
| 1528675121 | Jennifer Turf | Pharmacist | 2750 Broadway St, Boulder, CO 80304-3586 | 2020-09-28 |
| 1174130702 | Dave Milton | Pharmacist | 2750 Broadway St, Boulder, CO 80304-3586 | 2020-09-28 |
| 1437778057 | Poudre Valley Medical Group, LLC | Internal Medicine | 2750 Broadway St, Boulder, CO 80304-3573 | 2020-04-14 |
| 1013551852 | Reform Health & Rehab, LLC | Clinic/Center | 2750 Broadway St, Boulder, CO 80304-3573 | 2019-11-05 |
| 1477101608 | Boulder Community Health | Clinic/Center | 2750 Broadway St, Boulder, CO 80304-3586 | 2019-08-30 |
| 1144878208 | Boulder Community Health | Clinical Medical Laboratory | 2750 Broadway St, Boulder, CO 80304-3573 | 2019-08-30 |
| 1114579950 | Aaron M Shaver | Physical Therapist | 2750 Broadway St, Boulder, CO 80304-3573 | 2019-07-11 |
| 1962973099 | Alena Mecomber | Social Worker | 2750 Broadway St, Boulder, CO 80304-3573 | 2018-12-16 |
| 1396227864 | Kelly Korte | Nurse Practitioner | 2750 Broadway St, Boulder, CO 80304-3573 | 2018-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720605256 | Evol.v Chiropractic LLC | Chiropractor | 2401 Broadway #208, Boulder, CO 80304 | 2020-07-01 |
| 1760038723 | Patrica Anne Zeyher | Counselor | 100 Alpine Ave., Boulder, CO 80304 | 2019-08-15 |
| 1356855928 | Opal Counseling Center, LLC | Counselor | 1480 Lee Hill Dr. #7, Boulder, CO 80304 | 2017-11-19 |
| 1831608603 | Lesley Ann Cloke | Dietitian, Registered | 1895 Bluff St., Unit C, Boulder, CO 80304 | 2017-09-25 |
| 1790209740 | Megan Litwiller | Occupational Therapist | 810 Maxwell Ave, Boulder, CO 80304 | 2017-08-01 |
| 1285163774 | Nadine Martin | Registered Nurse | 311 Mapleton Ave # 331, Boulder, CO 80304 | 2017-06-08 |
| 1598119281 | Megan Cronin Larson | Social Worker | 825 S. Broadway Street, Boulder, CO 80304 | 2016-04-19 |
| 1760844237 | Rafia Rebeck | Counselor | 1235 Elder Ave #7, Boulder, CO 80304 | 2016-03-24 |
| 1629441688 | Jennifer S Delaney | Counselor | 2334 Broadway, Ste. B, Boulder, CO 80304 | 2015-11-12 |
| 1891162301 | Kingston Dialysis LLC | Clinic/Center | 2880 Folsom St Ste 110, Boulder, CO 80304 | 2015-09-01 |
| Find all providers in zip 80304 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386919793 | Laura Beth Hundemann | Physician Assistant | 2919 Valmont Rd Ste 204, Boulder, CO 80301-1350 | 2012-03-19 |
| 1356326888 | Alison Merser Moore | Physician Assistant | 1949 Pearl St, Boulder, CO 80302-4496 | 2005-12-07 |
| 1184175952 | Reed P Fischer | Physician Assistant | 1755 48th St Ste 200, Boulder, CO 80301-2712 | 2016-10-17 |
| 1366802035 | Rachel Morr | Physician Assistant | 2525 13th St, Boulder, CO 80304-4104 | 2016-02-24 |
| 1386918977 | Jennifer Lau Stanzel | Physician Assistant | 4745 Arapahoe Ave, Suite 110, Boulder, CO 80303-1080 | 2012-02-29 |
| 1417268970 | Zachary D Kahn | Physician Assistant | 2750 Broadway St, Boulder, CO 80304-3573 | 2010-06-29 |
| 1770812588 | Jonathan Ellis Welker | Physician Assistant | 4801 Riverbend Rd Ste 200, Boulder, CO 80301-2613 | 2009-12-08 |
| 1295068682 | Melissa J Guerri | Physician Assistant | 4745 Arapahoe Ave, #130, Boulder, CO 80303-1080 | 2009-09-16 |
| 1528297439 | Rebecca Jane Barnes | Physician Assistant | 805 S Broadway St, Ste 103, Boulder, CO 80305-5971 | 2009-07-13 |
| 1023140035 | Darrin Paul Guitreau | Physician Assistant | 4895 Riverbend Rd, Boulder, CO 80301-2640 | 2007-03-12 |
| Find all providers in BOULDER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.