Healthcare Provider Details

I. General information

NPI: 1215824321
Provider Name (Legal Business Name): SYDNEY ANN WELLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S CLARKSON ST STE 100
ENGLEWOOD CO
80113-3945
US

IV. Provider business mailing address

3601 S CLARKSON ST STE 100
ENGLEWOOD CO
80113-3945
US

V. Phone/Fax

Practice location:
  • Phone: 720-833-0400
  • Fax:
Mailing address:
  • Phone: 720-833-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0009185
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: