Provider Demographics
NPI:1477992956
Name:LEFKOWICZ, AMY BAKER (NNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:BAKER
Last Name:LEFKOWICZ
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 LILAC ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1041
Mailing Address - Country:US
Mailing Address - Phone:303-246-3689
Mailing Address - Fax:
Practice Address - Street 1:1090 LILAC ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1041
Practice Address - Country:US
Practice Address - Phone:303-246-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP 0990890363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal