Individual
MICHELENE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3292 PEORIA ST, AURORA, CO 80010-1517
(303) 360-6276
(303) 467-5355
Mailing address
3701 S BROADWAY, ENGLEWOOD, CO 80113-3611
(303) 360-6276
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0000444
CO
Other
Enumeration date
08/18/2005
Last updated
04/12/2016
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