Healthcare Provider Details

I. General information

NPI: 1770133761
Provider Name (Legal Business Name): TERI NOVOSEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7380 W 52ND AVE UNIT I
ARVADA CO
80002-3719
US

IV. Provider business mailing address

7380 W 52ND AVE UNIT I
ARVADA CO
80002-3719
US

V. Phone/Fax

Practice location:
  • Phone: 303-463-5941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1220
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5511
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0005980
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: