Healthcare Provider Details

I. General information

NPI: 1760886444
Provider Name (Legal Business Name): AMY HARSANT PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2014
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9695 S YOSEMITE ST STE 385
LONE TREE CO
80124-2890
US

IV. Provider business mailing address

9695 S YOSEMITE ST STE 385
LONE TREE CO
80124-2890
US

V. Phone/Fax

Practice location:
  • Phone: 303-715-7119
  • Fax: 303-715-7119
Mailing address:
  • Phone: 303-715-7119
  • Fax: 303-715-7119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085-005849
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-05289
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0005849
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: