Search › Alaska › 363A00000X
Jesse Ennis, PA-C
NPI 1063810844 · on the registry since 2014 · sole proprietor
Practice
- Address
- 4201 Bartlett St
Homer, AK 99603 - Phone
- (907) 235-7000
- Organisation at this address
- Kachemak Bay Medical Clinic
South Peninsula Hospital, IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Additional practice sites
- 16951 E Quincy Ave, Aurora, CO
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- CO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-04-23
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska