Provider Demographics
NPI:1518591759
Name:JENKOT, JULIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:JENKOT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S POTOMAC ST STE 230
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5448
Mailing Address - Country:US
Mailing Address - Phone:303-369-1077
Mailing Address - Fax:303-369-9785
Practice Address - Street 1:1550 S POTOMAC ST STE 230
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5448
Practice Address - Country:US
Practice Address - Phone:303-369-1077
Practice Address - Fax:303-369-9785
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.007543363AM0700X
COPA.0006494363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical