Healthcare Provider Details

I. General information

NPI: 1902935018
Provider Name (Legal Business Name): JENNIFER FAITH IVINSON M.A. CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 E 19TH AVE # B030
DENVER CO
80218-1007
US

IV. Provider business mailing address

1056 E 19TH AVE # B030
DENVER CO
80218-1007
US

V. Phone/Fax

Practice location:
  • Phone: 303-864-5951
  • Fax: 303-730-7544
Mailing address:
  • Phone: 303-864-5951
  • Fax: 303-730-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number338
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number338
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: