Individual
JESSICA K KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3212 E 104TH AVE, THORNTON, CO 80233-4406
(303) 861-7878
Mailing address
3212 E 104TH AVE, THORNTON, CO 80233-4406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004318
VA
363A00000X
Physician Assistant
Primary
PA0004631
CO
Other
Enumeration date
09/12/2013
Last updated
05/08/2019
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