Provider Demographics
NPI:1124215884
Name:LAMONICA, JAMI L (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:L
Last Name:LAMONICA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N UNION BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-2828
Mailing Address - Country:US
Mailing Address - Phone:719-630-1006
Mailing Address - Fax:716-630-0688
Practice Address - Street 1:1605 N UNION BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-2828
Practice Address - Country:US
Practice Address - Phone:719-630-1006
Practice Address - Fax:716-630-0688
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005220363AM0700X
FLPA9105019363AM0700X
CO3151363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical