Individual
JENNA TATGENHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
350 INDIANA ST STE 250, GOLDEN, CO 80401-5074
(720) 898-9427
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(303) 763-4900
(303) 763-5495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006736
CO
363AS0400X
Surgical Physician Assistant
PA.0006736
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000198401
—
CO
Enumeration date
07/08/2014
Last updated
03/05/2025
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