Healthcare Provider Details

I. General information

NPI: 1265281471
Provider Name (Legal Business Name): ALLISON JANEDIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2024
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 S CHAMBERS RD
ENGLEWOOD CO
80112-3276
US

IV. Provider business mailing address

8401 S CHAMBERS RD
ENGLEWOOD CO
80112-3276
US

V. Phone/Fax

Practice location:
  • Phone: 303-373-2008
  • Fax:
Mailing address:
  • Phone: 303-373-2008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0009613
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: