Provider Demographics
NPI:1477956019
Name:SESSIONS, MALLORY (PA-C)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:SESSIONS
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 1:4500 E 9TH AVE
Mailing Address - Street 2:SUITE 610
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3912
Mailing Address - Country:US
Mailing Address - Phone:303-316-7048
Mailing Address - Fax:303-316-7061
Practice Address - Street 1:4500 E 9TH AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3912
Practice Address - Country:US
Practice Address - Phone:303-316-7048
Practice Address - Fax:303-316-7061
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0004078363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical