Individual
MRS. JEANNIE HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4507
(303) 436-6000
Mailing address
215 E ELIZABETH ST, FORT COLLINS, CO 80524-3703
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0005195
CO
Other
Enumeration date
11/10/2017
Last updated
05/16/2019
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