Provider Demographics
NPI:1871089235
Name:AKSAMIT, CLAIRE (PA-C)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:AKSAMIT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 ROCKY MOUNTAIN AVE
Mailing Address - Street 2:NMOB SUITE 2200
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9004
Mailing Address - Country:US
Mailing Address - Phone:702-037-2509
Mailing Address - Fax:970-203-7256
Practice Address - Street 1:2500 ROCKY MOUNTAIN AVE
Practice Address - Street 2:NMOB SUITE 2200
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538
Practice Address - Country:US
Practice Address - Phone:702-037-2509
Practice Address - Fax:970-203-7256
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08157363AS0400X
COPA.0006039363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical