Most Relevant Information
Provider Data
| NPI Number: | 1003369240 |
| Provider Name: | JENNIFER PENCE PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA2019-0014 |
Most Important Dates
| Enumeration Date: | 07/23/2016 |
| Last Updated: | 07/24/2024 |
Provider Practice Location
735 US HIGHWAY 24
LEADVILLE
CO
804613978
Practice Location Phone/Fax
| Phone: | 7194860500 |
| Fax: | 7194863966 |
Provider Mailing Location
1100 CENTRAL AVE SE
ALBUQUERQUE
NM
871064934
Provider Mailing Phone/Fax
| Phone: | 5058411234 |
| Fax: |