Individual
AMY KOIKE BOUHABIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13001 E 17TH PL RM E7019, AURORA, CO 80045-2570
(303) 724-7963
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7403
CO
363AM0700X
Medical Physician Assistant
Primary
PA.0007403
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2021
Last updated
03/15/2023
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