Healthcare Provider Details

I. General information

NPI: 1306167648
Provider Name (Legal Business Name): JESSICA S OLSHESKY CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 06/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 E DICKENSON PL
DENVER CO
80222-6012
US

IV. Provider business mailing address

1042 LOGAN ST APT 302
DENVER CO
80203-3085
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-6646
  • Fax:
Mailing address:
  • Phone: 630-204-5377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number13962
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: