Provider Demographics
NPI:1184053480
Name:LEUNG, CONNIE CHEN (PA)
Entity type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:CHEN
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:9094 E MINERAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-7201
Mailing Address - Country:US
Mailing Address - Phone:303-694-3200
Mailing Address - Fax:303-694-2680
Practice Address - Street 1:9094 E MINERAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-7201
Practice Address - Country:US
Practice Address - Phone:303-694-3200
Practice Address - Fax:303-694-2680
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0003790363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical