| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RACHEL SAVANNA POVILUS | 1750980298 | 2020-10-24 |
Rachel Savanna Povilus is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1750980298. Registration indicates Rachel Savanna Povilus is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Rachel Savanna Povilus PA-C |
| Other Provider Name | Rachel Savanna Wolfe |
| Practice Office Address | 600 S. AIRPORT RD BLDG C, STE D LONGMONT, CO US |
| Practice Office Telephone | 3034942705 |
| Practice Office Fax | 3034942706 |
| Mailing Address | 600 S. AIRPORT RD BLDG C, STE D LONGMONT, CO 80503 US |
| Business Telephone | 3034942705 |
| Business Fax | 3034942706 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers |