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General NPI Number Information
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NPI Number | 1417283722
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Entity Type | Individual
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Provider Name | AMY LYNNE OSSIAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 1001 S PERRY ST STE 101B
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City | CASTLE ROCK
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State | CO
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Zip | 80104-1921
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Country | US
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Telephone | 303-699-1395
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 16TH ST UNIT 212
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City | DENVER
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State | CO
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Zip | 80202-5184
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Country | US
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Telephone | 720-375-3811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAL 2845
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 7752075-1206
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License Number State | UT
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