Healthcare Provider Details

I. General information

NPI: 1023346723
Provider Name (Legal Business Name): JENNIFER SUSAN HOLMES MEDICAL ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER SUSAN HOLMES MEDICAL ASSISTANT

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10065 E HARVARD AVE STE 400
DENVER CO
80231-5943
US

IV. Provider business mailing address

8842 DUDLEY ST
WESTMINSTER CO
80021-4676
US

V. Phone/Fax

Practice location:
  • Phone: 303-614-1492
  • Fax:
Mailing address:
  • Phone: 303-246-4088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: