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General NPI Number Information
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NPI Number | 1619335486
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Entity Type | Individual
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Provider Name | JASMINE WELLS PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 730 W HAMPDEN AVE STE 200
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2129
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Country | US
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Telephone | 877-360-8929
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Fax |
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Provider Business Mailing Address
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Address Line | 466 ENTRADA DR
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City | GOLDEN
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State | CO
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Zip | 80401-4869
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Country | US
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Telephone | 907-830-4266
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Fax |
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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 | PA.0004548
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License Number State | CO
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