Healthcare Provider Details

I. General information

NPI: 1720566359
Provider Name (Legal Business Name): AMY BREEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2018
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 CROWN CREST BLVD STE 200COLO
PARKER CO
80138-8882
US

IV. Provider business mailing address

9403 CROWN CREST BLVD STE 200COLO
PARKER CO
80138-8882
US

V. Phone/Fax

Practice location:
  • Phone: 303-230-0699
  • Fax: 303-320-0897
Mailing address:
  • Phone: 303-230-0699
  • Fax: 303-320-0897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberPA.0005452
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.5452
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: