Healthcare Provider Details
I. General information
NPI: 1447896592
Provider Name (Legal Business Name): JESSICA LYNN FALLIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/25/2019
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16951 E QUINCY AVE
AURORA CO
80015-1901
US
IV. Provider business mailing address
16951 E QUINCY AVE
AURORA CO
80015-1901
US
V. Phone/Fax
- Phone: 303-752-5480
- Fax: 303-752-5481
- Phone: 303-752-5480
- Fax: 303-752-5481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | APN.0994751-NP |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: