Jessica Herron
Individual provider Active NPI Physical Therapist · Evans, CO
NPI 1073005252 · NPPES record last updated Jun 4, 2018
Key facts
- NPI
- 1073005252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 2720 Crescent Cove Dr Apt 202
Evans, CO 80620-3661 - Phone
- (720) 936-9583
- NPI assigned
- Jun 4, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
2720 Crescent Cove Dr Apt 202
Evans, CO 80620-3661
Mailing address
2720 Crescent Cove Dr Apt 202
Evans, CO 80620-3661
Phone (720) 936-9583
Other providers in Evans, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.