MEDICARE: JENNA ESTRADA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1770386096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA ESTRADA PA-C

Provider Business Mailing Address
First Line	:	2387 HOUGHTON HOLLOW DR
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48911-8418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1541 GULL RD STE 100
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49048-1645
Country	:	US
Telephone Number	:	269-381-7380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	01/07/2026

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Directions to “ JENNA ESTRADA PA-C” Practice Location

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