Individual
AMY KENNEDY ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.0001375
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124168100
—
WY
05
—
93626827
—
CO
01
—
P00433284
RR MEDICARE
CO
Enumeration date
04/08/2006
Last updated
12/16/2019
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