Healthcare Provider Details

I. General information

NPI: 1174504948
Provider Name (Legal Business Name): RHONDA M HAVER P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 01/31/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE SUITE 3300
DENVER CO
80218-1216
US

IV. Provider business mailing address

4900 S MONACO ST SUITE 210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-837-0072
  • Fax: 303-837-0075
Mailing address:
  • Phone: 303-837-0072
  • Fax: 303-837-0075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1672
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: