Healthcare Provider Details

I. General information

NPI: 1003355306
Provider Name (Legal Business Name): AMANDA LYNN BEFFERMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11990 GRANT ST STE 101
NORTHGLENN CO
80233-1122
US

IV. Provider business mailing address

11990 GRANT ST STE 101
NORTHGLENN CO
80233-1122
US

V. Phone/Fax

Practice location:
  • Phone: 303-537-8152
  • Fax: 303-200-8416
Mailing address:
  • Phone: 303-537-8152
  • Fax: 303-200-8416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number020647
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0005731
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: