Healthcare Provider Details
I. General information
NPI: 1932560844
Provider Name (Legal Business Name): JODY JAFFE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/19/2016
Last Update Date: 03/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7735 WADSWORTH BLVD #D/24
ARVADA CO
80003-2143
US
IV. Provider business mailing address
7155 E 38TH AVE
DENVER CO
80207-1630
US
V. Phone/Fax
- Phone: 303-467-3766
- Fax: 303-425-6101
- Phone: 303-321-7625
- Fax: 303-861-0268
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN.0069860 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367A00000X |
| Taxonomy | Advanced Practice Midwife |
| License Number | APN.0000310-CNM |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: