Provider Demographics
NPI:1457328031
Name:SEUFER, ABBEY PRUDHOMME (PA-C)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:PRUDHOMME
Last Name:SEUFER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:NICOLE
Other - Last Name:PRUDHOMME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1107 S LEMAY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3957
Mailing Address - Country:US
Mailing Address - Phone:970-493-7442
Mailing Address - Fax:970-493-2990
Practice Address - Street 1:1107 S LEMAY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3957
Practice Address - Country:US
Practice Address - Phone:970-493-7442
Practice Address - Fax:970-493-2990
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2137363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18231276Medicaid
COP00621767OtherRAILROAD MEDICARE PART B
COC804627Medicare PIN
COP00621767OtherRAILROAD MEDICARE PART B