Healthcare Provider Details

I. General information

NPI: 1386917581
Provider Name (Legal Business Name): KATHLEEN MARIE JENNER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 E CENTRETECH PKWY
AURORA CO
80011-9045
US

IV. Provider business mailing address

16601 E CENTRETECH PKWY
AURORA CO
80011-9045
US

V. Phone/Fax

Practice location:
  • Phone: 303-739-4938
  • Fax:
Mailing address:
  • Phone: 303-739-4938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number18396
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: