Healthcare Provider Details

I. General information

NPI: 1881206175
Provider Name (Legal Business Name): AMANDA ELIZABETH BROWN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 04/05/2022
Certification Date: 04/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 YOSEMITE STREET SUITE 100
DENVER CO
80238
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 720-516-8902
  • Fax:
Mailing address:
  • Phone: 970-624-4451
  • Fax: 970-490-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0006395
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: