Healthcare Provider Details

I. General information

NPI: 1245104892
Provider Name (Legal Business Name): JESSICA PLOWMAN RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 FOXGLOVE TRL
BROOMFIELD CO
80023-8758
US

IV. Provider business mailing address

5120 FOXGLOVE TRL
BROOMFIELD CO
80023-8758
US

V. Phone/Fax

Practice location:
  • Phone: 801-574-3396
  • Fax:
Mailing address:
  • Phone: 801-574-3396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number953916
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: