Individual
AMANDA JEAN SEVVOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3555 LUTHERAN PKWY STE 340, WHEAT RIDGE, CO 80033-6039
(303) 996-6005
(303) 420-8831
Mailing address
15747 W 74TH PL, ARVADA, CO 80007-7965
(303) 921-2038
(303) 420-8831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801047956
—
CO
Enumeration date
10/07/2008
Last updated
08/05/2019
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