Individual
JESSICA JOVANA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 S POTOMAC ST, AURORA, CO 80012-5411
(303) 695-2628
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0003977
CO
363A00000X
Physician Assistant
0159521
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59124377
—
CO
01
—
P01401645
RAILROAD MEDICARE
CO
Enumeration date
09/26/2012
Last updated
05/11/2015
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