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Individual

AMANDA DAWN WAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488
Mailing address
1400 E BOULDER ST, SUITE 600, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
(719) 364-6488

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2665
CO
363AS0400X
Surgical Physician Assistant
Primary
2665
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
29855039
CO
Enumeration date
09/29/2008
Last updated
02/10/2020
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