Provider Demographics
NPI:1992006647
Name:SELBY, AMANDA L (CRNA)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:L
Last Name:SELBY
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:1819 DENVER WEST DR
Mailing Address - Street 2:200
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3118
Mailing Address - Country:US
Mailing Address - Phone:303-422-9438
Mailing Address - Fax:303-422-9474
Practice Address - Street 1:1819 DENVER WEST DR
Practice Address - Street 2:200
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-3118
Practice Address - Country:US
Practice Address - Phone:303-422-9438
Practice Address - Fax:303-422-9474
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO100014367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered