Jessica Lynn Eret, PA

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APN.0991407-NP Issued in CO

Practice address

12774 Colorado Blvd
Suite #141
Thornton, CO 80241

Phone

(303) 996-6005

NPI assigned

Oct 9, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jessica Gillesse Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1164826822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 LUTHERAN PKWY",
            "address_2": "SUITE #340 & 370",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336021",
            "telephone_number": "303-996-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12774 COLORADO BLVD",
            "address_2": "SUITE #141",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80241",
            "telephone_number": "303-996-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERET",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CO",
            "license": "APN.0991407-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "GILLESSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaylan Engen, DC
• Suzan Lauri Enlow, MA
• Bonnie Gray Ennis, LCSW, LAC
• Jasmine Enriquez
• Byeong Ho Eom
• Eric Johnson LLC
• Lora Lee Erickson, LPC
• Kassidy Ann Erikson
• Dorothea Lorell Erwin, NP
• Victoria Esher, RN

• Pediatric Nurse Practitioner in Thornton, CO
• Providers in Thornton, CO by specialty
• Pediatric Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.