Provider Demographics
NPI:1184762775
Name:PEARSON, JENNIFER (PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:PEARSON
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 E BRIARWOOD AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3846
Mailing Address - Country:US
Mailing Address - Phone:303-680-9150
Mailing Address - Fax:303-680-9149
Practice Address - Street 1:13111 E BRIARWOOD AVE STE 215
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3846
Practice Address - Country:US
Practice Address - Phone:303-680-9150
Practice Address - Fax:303-680-9149
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical