MEDICARE: RACHEL SAVANNA POVILUS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	6563	CO

General Provider Information

NPI Number	:	1750980298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL SAVANNA POVILUS PA-C

Provider Business Mailing Address
First Line	:	382 S ARTHUR AVE
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-3094
Country	:	US
Telephone Number	:	303-604-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1551 PROFESSIONAL LN UNIT 290
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-6970
Country	:	US
Telephone Number	:	303-604-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2020
Last Update Date	:	05/04/2026

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