Provider Demographics
NPI:1174504948
Name:HAVER, RHONDA M (PA)
Entity Type:Individual
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First Name:RHONDA
Middle Name:M
Last Name:HAVER
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Gender:F
Credentials:PA
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-837-0072
Mailing Address - Fax:303-837-0075
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:SUITE 3300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-837-0072
Practice Address - Fax:303-837-0075
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-01-31
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Provider Licenses
StateLicense IDTaxonomies
CO1672363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18857841Medicaid
COP87540Medicare UPIN
COP00885582Medicare PIN
CO18857841Medicaid
COCOA102914Medicare PIN