Healthcare Provider Details

I. General information

NPI: 1376843623
Provider Name (Legal Business Name): JENNIFER SUE FIGHTMASTER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10190 BANNOCK ST STE 106
NORTHGLENN CO
80260-6052
US

IV. Provider business mailing address

10190 BANNOCK ST STE 106
NORTHGLENN CO
80260-6052
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-1229
  • Fax:
Mailing address:
  • Phone: 720-295-1229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number178571
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number99015
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: