Healthcare Provider Details

I. General information

NPI: 1891590493
Provider Name (Legal Business Name): WELLNESS PROJECT 365
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11983 SONG BIRD HILLS ST
PARKER CO
80138-8687
US

IV. Provider business mailing address

11983 SONG BIRD HILLS ST
PARKER CO
80138-8687
US

V. Phone/Fax

Practice location:
  • Phone: 303-437-6961
  • Fax:
Mailing address:
  • Phone: 303-437-6961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER BOLTON
Title or Position: OWNER AND PRACTIONER
Credential: PHD, RDN, IBCLC
Phone: 303-437-6961