Healthcare Provider Details

I. General information

NPI: 1013873017
Provider Name (Legal Business Name): JASMIN BOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 S ELM AVE
EATON CO
80615-8264
US

IV. Provider business mailing address

674 RANCHHAND DR
BERTHOUD CO
80513-2698
US

V. Phone/Fax

Practice location:
  • Phone: 970-438-4000
  • Fax:
Mailing address:
  • Phone: 720-226-4349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1001510-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: