Healthcare Provider Details

I. General information

NPI: 1043251515
Provider Name (Legal Business Name): JENNIFER JONES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 CHEYENNE AVE
LOVELAND CO
80538-4244
US

IV. Provider business mailing address

1627 E 18TH ST
LOVELAND CO
80538-4209
US

V. Phone/Fax

Practice location:
  • Phone: 970-203-6801
  • Fax: 970-203-6821
Mailing address:
  • Phone: 970-663-0135
  • Fax: 970-461-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP-792
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number90626
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: