Provider Demographics
NPI:1144469354
Name:RANDOLPH, JEANNINE MARIE FERRIGNO (DMS, CHA, PA)
Entity type:Individual
Prefix:DR
First Name:JEANNINE
Middle Name:MARIE FERRIGNO
Last Name:RANDOLPH
Suffix:
Gender:F
Credentials:DMS, CHA, PA
Other - Prefix:
Other - First Name:JEANNINE
Other - Middle Name:MARIE
Other - Last Name:RANDOLPH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMS, CHA, PA
Mailing Address - Street 1:1707 COLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3219
Mailing Address - Country:US
Mailing Address - Phone:303-763-4900
Mailing Address - Fax:303-972-0026
Practice Address - Street 1:32135 CASTLE CT STE 101
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-8006
Practice Address - Country:US
Practice Address - Phone:303-679-8500
Practice Address - Fax:303-972-0026
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0001527363A00000X
CO1527207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant