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General NPI Number Information
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NPI Number | 1619286424
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Entity Type | Individual
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Provider Name | AMY WYATT ROSENBLUM PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 955 LAWRENCE WAY SUITE 150
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City | DENVER
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State | CO
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Zip | 80204
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Country | US
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Telephone | 303-615-9999
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Fax | 720-778-5850
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Provider Business Mailing Address
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Address Line | PO BOX 173362
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City | DENVER
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State | CO
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Zip | 80217-3362
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Country | US
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Telephone | 303-615-9999
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Fax | 720-778-5850
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DT07529
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License Number State | VA
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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 |
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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