MEDICARE: JENNIE H WINDSCHEFFEL 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	363AM0700X	Medical Physician Assistant	2431	CO
2	363AS0400X	Surgical Physician Assistant
3	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972680585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIE H WINDSCHEFFEL PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1727
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81502-1727
Country	:	US
Telephone Number	:	970-263-2619
Fax Number	:	970-263-2691

Provider Business Practice Location Address
First Line	:	2373 G RD STE 100
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-1003
Country	:	US
Telephone Number	:	970-245-0484
Fax Number	:	970-241-1681

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/02/2022

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