Provider Demographics
NPI:1447221049
Name:CONNELL, SILVIA G (PAC)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:G
Last Name:CONNELL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:SILVIA
Other - Middle Name:G
Other - Last Name:STOPKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:9777 S YOSEMITE ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-3191
Mailing Address - Country:US
Mailing Address - Phone:303-699-7355
Mailing Address - Fax:303-699-5486
Practice Address - Street 1:9777 S YOSEMITE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-3191
Practice Address - Country:US
Practice Address - Phone:303-699-7355
Practice Address - Fax:303-699-5486
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2484363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q14853Medicare UPIN