Healthcare Provider Details

I. General information

NPI: 1134598196
Provider Name (Legal Business Name): JENNY I. MACEK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNY IN

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 29TH ST FL 2
GREELEY CO
80634-5474
US

IV. Provider business mailing address

6767 29TH ST FL 2
GREELEY CO
80634-5474
US

V. Phone/Fax

Practice location:
  • Phone: 970-652-2491
  • Fax: 970-652-2492
Mailing address:
  • Phone: 970-652-2491
  • Fax: 970-652-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1660
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA11170
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13247
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: