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General NPI Number Information
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NPI Number | 1073140190
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Entity Type | Individual
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Provider Name | JESSE SHELDON PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 165 S UNION BLVD STE 400
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City | LAKEWOOD
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State | CO
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Zip | 80228-2219
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Country | US
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Telephone | 303-351-5995
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Fax | 720-925-5897
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Provider Business Mailing Address
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Address Line | 5445 DTC PKWY STE 1130
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3038
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Country | US
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Telephone | 720-749-5599
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Fax | 720-925-5897
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0006916
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License Number State | CO
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