Healthcare Provider Details

I. General information

NPI: 1043437452
Provider Name (Legal Business Name): JENNIFER P DUGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 S PARKER RD STE 400
AURORA CO
80014-1677
US

IV. Provider business mailing address

9838 W 70TH PL
ARVADA CO
80004-1628
US

V. Phone/Fax

Practice location:
  • Phone: 303-636-3302
  • Fax:
Mailing address:
  • Phone: 303-463-1737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number16720
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: