Healthcare Provider Details

I. General information

NPI: 1376279166
Provider Name (Legal Business Name): JENNIFER LEIGH HUTTON MS, APRN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 E 16TH AVE
AURORA CO
80045-2545
US

IV. Provider business mailing address

6657 W CEDAR PL
LAKEWOOD CO
80226-2118
US

V. Phone/Fax

Practice location:
  • Phone: 720-848-0000
  • Fax:
Mailing address:
  • Phone: 303-257-1934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number0997301
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: