Provider Demographics
NPI:1477163780
Name:EDWARDS, ALYCIA MARIE (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALYCIA
Middle Name:MARIE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
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Mailing Address - Street 1:5445 DTC PKWY STE 1130
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3038
Mailing Address - Country:US
Mailing Address - Phone:720-749-5599
Mailing Address - Fax:720-925-5897
Practice Address - Street 1:3491 E HARMONY RD STE 230
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8824
Practice Address - Country:US
Practice Address - Phone:970-449-0285
Practice Address - Fax:720-925-5897
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2024-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X, 390200000X
COPA.0006978363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program