Individual
JAMIE PEPI SHELSTAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-S
Contact information
Practice address
2501 KENTUCKY AVE, PADUCAH, KY 42003-3813
(270) 575-2100
Mailing address
2236 STUART ST, LONGMONT, CO 80501-7539
(303) 718-1646
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1157375
CO
363A00000X
Physician Assistant
PA2522
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2019
Last updated
05/31/2022
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