Healthcare Provider Details

I. General information

NPI: 1942926910
Provider Name (Legal Business Name): JESSICA UNELL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HEALTH PARK DR STE 240
LOUISVILLE CO
80027-4644
US

IV. Provider business mailing address

10290 RIDGEGATE CIR
LONE TREE CO
80124-5331
US

V. Phone/Fax

Practice location:
  • Phone: 303-665-0150
  • Fax:
Mailing address:
  • Phone: 303-788-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA.0008505
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: