Provider Demographics
NPI:1093273591
Name:ENGEN, KAYLEIGH ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAYLEIGH
Middle Name:ANN
Last Name:ENGEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10900 W 44TH AVE UNIT 200
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2742
Mailing Address - Country:US
Mailing Address - Phone:720-923-1239
Mailing Address - Fax:303-284-4082
Practice Address - Street 1:10900 W 44TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2742
Practice Address - Country:US
Practice Address - Phone:303-993-1330
Practice Address - Fax:303-957-5757
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0005595363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant