Provider Demographics
NPI:1811331812
Name:DENNISON, JOSEPHINE FRANCES (PA-C)
Entity type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:FRANCES
Last Name:DENNISON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:DENNISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:4638 S WHITE LN
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-1111
Mailing Address - Country:US
Mailing Address - Phone:303-972-4504
Mailing Address - Fax:
Practice Address - Street 1:3333 REGIS BLVD F-12
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1099
Practice Address - Country:US
Practice Address - Phone:303-458-3558
Practice Address - Fax:303-964-5406
Is Sole Proprietor?:No
Enumeration Date:2013-04-20
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1651363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1651OtherSTATE OF COLORADO