Individual
AMY WYATT ROSENBLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
955 LAWRENCE WAY, SUITE 150, DENVER, CO 80204
(303) 615-9999
(720) 778-5850
Mailing address
PO BOX 173362, DENVER, CO 80217-3362
(303) 615-9999
(720) 778-5850
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DT07529
VA
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619286424
—
VA
01
—
VVS807A
MEDICARE
VA
Enumeration date
09/28/2010
Last updated
01/27/2025
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