Individual
SAVANNAH CARLY SIEVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631
(970) 810-5115
(970) 810-3897
Mailing address
1801 16TH ST, GREELEY, CO 80631
(970) 810-5115
(970) 810-3897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006189
CO
363A00000X
Physician Assistant
PA12675
TX
363AM0700X
Medical Physician Assistant
0010-05769
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398455101
—
TX
01
—
398455102
MEDICAID-CSHCN
TX
01
—
8LB699
BCBS
TX
Enumeration date
08/05/2015
Last updated
04/20/2022
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