Individual
JACQUELYN KANTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1890 N REVERE CT, AURORA, CO 80045-7464
(720) 848-0000
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4597
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0008304
CO
363A00000X
Physician Assistant
PA9118206
FL
Other
Enumeration date
12/06/2023
Last updated
03/05/2024
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