Provider Demographics
NPI:1871685263
Name:FLANNERY, SEAN DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:DAVID
Last Name:FLANNERY
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Gender:M
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:4045 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4642
Mailing Address - Country:US
Mailing Address - Phone:303-425-6012
Mailing Address - Fax:303-467-9211
Practice Address - Street 1:4045 WADSWORTH BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4642
Practice Address - Country:US
Practice Address - Phone:303-425-6012
Practice Address - Fax:303-467-9211
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1155363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant