Lundell, Travis G.

Lundell, Travis G. is an individual health care provider with primary practice located at 1400 E Boulder St Ste 2508 , Colorado Springs CO 80909-5533. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Lundell, Travis G. can be contacted via phone (719) 365-6999.

Contact Information

Primary practice address
1400 E Boulder St Ste 2508 Colorado Springs CO 80909-5533
Phone: (719) 365-6999
Fax: (719) 365-2837
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 2014026440 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X ANT.0000138 Colorado

Profile Details

NPI number 1225446537
LBN Legal business name Lundell, Travis G.
Credentials AA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 30th, 2014
Last updated Nov 17th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225446537 NPPES
Missouri MEDICAID PENDING

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