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NPI Code Detail

MEDICARE: JORDAN RENEE DREILING PA-C

MEDICARE: JORDAN RENEE DREILING PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA.0008792CO
2363A00000XPhysician AssistantPA07508TX

General Provider Information

NPI Number : 1023387222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN RENEE DREILING PA-C
Provider Business Mailing Address
First Line : PO BOX 110429
Second Line :
City : AURORA
State : CO
Zip : 80042-0429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4125 BRIARGATE PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7804
Country : US
Telephone Number : 719-305-9035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2011
Last Update Date : 02/03/2026

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