Healthcare Provider Details

I. General information

NPI: 1104912575
Provider Name (Legal Business Name): JENNIFER L TAYLOR-COUSAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER L. TAYLOR M.D.

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 JACKSON ST NATIONAL JEWISH HEALTH
DENVER CO
80206-2761
US

IV. Provider business mailing address

1400 JACKSON ST NATIONAL JEWISH HEALTH
DENVER CO
80206-2761
US

V. Phone/Fax

Practice location:
  • Phone: 303-388-4461
  • Fax: 303-270-2206
Mailing address:
  • Phone: 303-388-4461
  • Fax: 303-398-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number48114
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number48114
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number48114
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: