Provider Demographics
NPI:1871739847
Name:CHAND, SHEENA ELSPET (PA)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:ELSPET
Last Name:CHAND
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:ELSPET
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:361 SECOND AVE SUITE 101
Mailing Address - Street 2:P.O. BOX 1086
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544
Mailing Address - Country:US
Mailing Address - Phone:303-652-9222
Mailing Address - Fax:303-652-9333
Practice Address - Street 1:361 SECOND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80544
Practice Address - Country:US
Practice Address - Phone:303-652-9222
Practice Address - Fax:303-652-9333
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20027363AM0700X
COPA0003560363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30923018Medicaid