Healthcare Provider Details

I. General information

NPI: 1649428152
Provider Name (Legal Business Name): EVELYN ALICE SDRULLA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 AQUAMARINE CT
CASTLE ROCK CO
80108-7781
US

IV. Provider business mailing address

1500 N GRANT ST STE 6456
DENVER CO
80203-1859
US

V. Phone/Fax

Practice location:
  • Phone: 303-721-7330
  • Fax: 720-488-6566
Mailing address:
  • Phone: 303-721-7330
  • Fax: 720-488-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1578
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: