MEDICARE: JENNIFER FARREN 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
1	363A00000X	Physician Assistant	0006798	CO

General Provider Information

NPI Number	:	1659948057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER FARREN PA-C

Provider Business Mailing Address
First Line	:	701 E HAMPDEN AVE STE 510
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2776
Country	:	US
Telephone Number	:	303-357-5455
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 E HAMPDEN AVE STE 510
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2776
Country	:	US
Telephone Number	:	303-357-5455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2021
Last Update Date	:	06/06/2021

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