Individual
KEN JENKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
421 W ADAMS, NATURITA, CO 81422
(970) 865-2665
(970) 865-2674
Mailing address
PO BOX 340, NATURITA, CO 81422-0340
(970) 865-2665
(970) 865-2674
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 1103
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020250699
WORKERS COMP
—
05
—
2712462
—
CO
01
—
840820573004
ROCKY MTN HMO
—
01
—
JEJ63808
ANTHEM BLUE CROSS
CO
Enumeration date
12/22/2006
Last updated
06/13/2013
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