Physician Compare National (NPI:1033542345)

HEALTHCARE PROVIDER: JESSICA KELNER D.O.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1033542345
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507145919
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170913001001
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KELNER
	Individual professional last name
Provider First Name	JESSICA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NOVA SOUTHEASTERN UNIV COLLEGE OF DENTAL MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1525 RALEIGH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	DENVER
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	802041374
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M