Provider Demographics
NPI:1003355306
Name:BEFFERMAN, AMANDA LYNN (PA-C)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:LYNN
Last Name:BEFFERMAN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11990 GRANT ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1122
Mailing Address - Country:US
Mailing Address - Phone:303-537-8152
Mailing Address - Fax:303-200-8416
Practice Address - Street 1:11990 GRANT ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80233-1122
Practice Address - Country:US
Practice Address - Phone:303-537-8152
Practice Address - Fax:303-200-8416
Is Sole Proprietor?:No
Enumeration Date:2017-02-20
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020647363A00000X
COPA.0005731363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant