Healthcare Provider Details

I. General information

NPI: 1831480417
Provider Name (Legal Business Name): JENNIFER ELIZABETH ANDERSON-TARVER CPM, RM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 08/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 W 29TH AVE
DENVER CO
80211-3712
US

IV. Provider business mailing address

2530 W 29TH AVE
DENVER CO
80211-3712
US

V. Phone/Fax

Practice location:
  • Phone: 720-496-9254
  • Fax: 888-909-6002
Mailing address:
  • Phone: 720-496-9254
  • Fax: 888-909-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMWR-128
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: