Healthcare Provider Details

I. General information

NPI: 1407579154
Provider Name (Legal Business Name): ASHLEY ELIZABETH ERWIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ELIZABETH BODNER

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 E BOULDER ST STE 101
COLORADO SPRINGS CO
80909-5740
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6300
  • Fax: 719-365-6094
Mailing address:
  • Phone: 970-624-4123
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA.0007662
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0007662
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: