Provider Demographics
NPI:1902429939
Name:SELCER, ALISON SHEA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:SHEA
Last Name:SELCER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ALISON
Other - Middle Name:SHEA
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10900 W 44TH AVE
Mailing Address - Street 2:UNIT 200
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2742
Mailing Address - Country:US
Mailing Address - Phone:720-923-1250
Mailing Address - Fax:303-284-4082
Practice Address - Street 1:10900 W 44TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2742
Practice Address - Country:US
Practice Address - Phone:303-993-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0006254363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical