Provider Demographics
NPI:1851060891
Name:COLLISON, MACEY ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MACEY
Middle Name:ELIZABETH
Last Name:COLLISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MACEY
Other - Middle Name:ELIZABETH
Other - Last Name:JUHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:4110 BRIARGATE PKWY STE 100B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7836
Practice Address - Country:US
Practice Address - Phone:719-364-0160
Practice Address - Fax:719-364-0161
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant