Individual
JEFFREY WAYNE ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 365-5000
Mailing address
PO BOX 173891, DENVER, CO 80217-3891
(877) 346-2211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0002465
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73230243
—
CO
Enumeration date
12/05/2006
Last updated
09/02/2025
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