Healthcare Provider Details

I. General information

NPI: 1699304667
Provider Name (Legal Business Name): JENNIFER R MOONEY, MSN, APRN-C, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 E EXPOSITION AVE STE 316
DENVER CO
80209-5032
US

IV. Provider business mailing address

3955 E EXPOSITION AVE STE 316
DENVER CO
80209-5032
US

V. Phone/Fax

Practice location:
  • Phone: 720-664-8020
  • Fax: 303-552-5720
Mailing address:
  • Phone: 720-664-8020
  • Fax: 303-552-5720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER R MOONEY
Title or Position: NURSE PRACTITIONER/OWNER
Credential: APRN-C
Phone: 785-564-0746