Individual
JENNIFER ILISSA CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1375 E 19TH AVE, DENVER, CO 80218-1114
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4390
CO
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026843
KAISER COMMERCIAL NUMBER
CO
05
—
66700051
—
CO
Enumeration date
06/03/2013
Last updated
06/10/2021
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