Individual
DARREN KYLE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
350 LYCKMAN PL, FOUNTAIN, CO 80817-2861
(719) 632-5700
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3193
CO
363A00000X
Physician Assistant
PA 19545
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3193
COLORADO STATE LICENSE
CO
01
—
PA 19545
MEDICAL BOARD OF CALIFORN
CA
Enumeration date
01/28/2008
Last updated
11/04/2015
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