Provider Demographics
NPI:1770278202
Name:JENSEN, KELSEY NICOLE (PA)
Entity type:Individual
Prefix:MISS
First Name:KELSEY
Middle Name:NICOLE
Last Name:JENSEN
Suffix:
Gender:
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:303-436-4949
Mailing Address - Fax:303-602-7601
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4597
Practice Address - Country:US
Practice Address - Phone:303-436-4949
Practice Address - Fax:303-602-7601
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPA.0007799363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical