Healthcare Provider Details

I. General information

NPI: 1710204821
Provider Name (Legal Business Name): JENELLE MARIE GIRARD ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7173 S HAVANA ST # 41
CENTENNIAL CO
80112-3891
US

IV. Provider business mailing address

90 N CORONA ST APT 1201
DENVER CO
80218-3885
US

V. Phone/Fax

Practice location:
  • Phone: 615-485-7399
  • Fax:
Mailing address:
  • Phone: 615-485-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0002502
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: