Provider Demographics
NPI:1144334350
Name:GOLDEN, SUSAN K (PA-C)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-330-0410
Mailing Address - Fax:303-330-0732
Practice Address - Street 1:1600 MID VALLEY DR
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-9006
Practice Address - Country:US
Practice Address - Phone:970-871-9770
Practice Address - Fax:970-871-9771
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07006216Medicaid
COS32317Medicare UPIN
COCO304678Medicare PIN