Provider Demographics
NPI:1538181615
Name:CATTELL, LAURA (PA-C)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:CATTELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:CATTELL
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:500 W. PACIFIC AVE
Mailing Address - Street 2:PO 1229
Mailing Address - City:TELLURIDE
Mailing Address - State:CO
Mailing Address - Zip Code:81435-1229
Mailing Address - Country:US
Mailing Address - Phone:970-728-3848
Mailing Address - Fax:970-728-3404
Practice Address - Street 1:500 W. PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TELLURIDE
Practice Address - State:CO
Practice Address - Zip Code:81435-1229
Practice Address - Country:US
Practice Address - Phone:970-728-3848
Practice Address - Fax:970-728-3404
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO985363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79024726Medicaid
CO79024726Medicaid