Provider Demographics
NPI:1619200466
Name:HOZIAN, ONDI ANDREA CROSSLAND (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ONDI
Middle Name:ANDREA CROSSLAND
Last Name:HOZIAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:CROSSLAND
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:925 S NIAGARA ST
Mailing Address - Street 2:SUITE 370
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1683
Mailing Address - Country:US
Mailing Address - Phone:303-321-2383
Mailing Address - Fax:303-223-3288
Practice Address - Street 1:925 S NIAGARA ST
Practice Address - Street 2:SUITE 370
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1683
Practice Address - Country:US
Practice Address - Phone:303-321-2383
Practice Address - Fax:303-223-3288
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA 0003973363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0OtherPENDING MEDICARE, MEDICAID NUMBERS, APPLICATION BEING REVIEWED
GAPENDINGMedicaid