Healthcare Provider Details

I. General information

NPI: 1780519355
Provider Name (Legal Business Name): JENNIFER HALL FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 70TH AVE
GREELEY CO
80634-4621
US

IV. Provider business mailing address

2001 70TH AVE
GREELEY CO
80634-4621
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-2500
  • Fax:
Mailing address:
  • Phone: 970-810-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.1002087-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.1655058
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: