Healthcare Provider Details

I. General information

NPI: 1023934510
Provider Name (Legal Business Name): JACENDA COLLEEN O'DWYER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 S QUEBEC ST STE 312A
GREENWOOD VILLAGE CO
80111-2208
US

IV. Provider business mailing address

26254 CENTENNIAL TRL
GOLDEN CO
80401-7213
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-2727
  • Fax:
Mailing address:
  • Phone: 860-573-7663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: