Provider Demographics
NPI:1881826618
Name:STALILONIS, JENNIFER CORRIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CORRIE
Last Name:STALILONIS
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:3455 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6028
Mailing Address - Country:US
Mailing Address - Phone:303-467-1400
Mailing Address - Fax:303-467-1467
Practice Address - Street 1:3455 LUTHERAN PKWY
Practice Address - Street 2:SUITE 290
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6028
Practice Address - Country:US
Practice Address - Phone:303-467-1400
Practice Address - Fax:303-467-1467
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2019-07-30
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Provider Licenses
StateLicense IDTaxonomies
COPAL2527363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical