Provider Demographics
NPI:1275675993
Name:ROLAND, JENNIFER R (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:ROLAND
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1715 IRON HORSE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-9617
Mailing Address - Country:US
Mailing Address - Phone:303-494-7773
Mailing Address - Fax:303-494-1104
Practice Address - Street 1:1840 FOLSOM ST STE 105
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5712
Practice Address - Country:US
Practice Address - Phone:303-763-4900
Practice Address - Fax:303-440-3251
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2024-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1503363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical