Provider Demographics
NPI:1548887649
Name:SERENA, SIENNA MONIQUE (PA-C)
Entity type:Individual
Prefix:
First Name:SIENNA
Middle Name:MONIQUE
Last Name:SERENA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SIENNA
Other - Middle Name:MONIQUE
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:19136 E STANFORD DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2860
Mailing Address - Country:US
Mailing Address - Phone:720-207-1126
Mailing Address - Fax:
Practice Address - Street 1:7351 E LOWRY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6083
Practice Address - Country:US
Practice Address - Phone:720-207-1126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.006291363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPA.0006291OtherCO STATE LICENSE