Basic Information
| Provider Information | |||||||||
| NPI: | 1851972210 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEELEY | ||||||||
| FirstName: | TAYLOR | ||||||||
| MiddleName: | DAWN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 S POTOMAC ST | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800125405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3034187600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 S POTOMAC ST | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800125405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9062414075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2021 | ||||||||
| LastUpdateDate: | 09/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363A00000X | PA.0006838 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.