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General NPI Number Information
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NPI Number | 1518582352
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Entity Type | Individual
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Provider Name | BIANCA MARIE SEIVLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 500 W 144TH AVE STE 230
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City | WESTMINSTER
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State | CO
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Zip | 80023-9328
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Country | US
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Telephone | 303-665-2603
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SUPERIOR DR STE 225
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City | SUPERIOR
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State | CO
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Zip | 80027-8661
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Country | US
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Telephone | 303-665-2603
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | PA.0005992
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0005992
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License Number State | CO
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