Healthcare Provider Details

I. General information

NPI: 1578073953
Provider Name (Legal Business Name): JESSICA YATES PASHA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LYNN YATES NP

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 POTOMAC ST STE 111
AURORA CO
80011-6743
US

IV. Provider business mailing address

1423 HOLLY ST
DENVER CO
80220-2621
US

V. Phone/Fax

Practice location:
  • Phone: 303-343-3121
  • Fax:
Mailing address:
  • Phone: 321-795-5657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0993354-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: