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General NPI Number Information
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NPI Number | 1891409868
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Entity Type | Individual
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Provider Name | JENNIFER NACIRI PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 5600 S QUEBEC ST STE 312A
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2208
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Country | US
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Telephone | 703-463-8847
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Fax |
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Provider Business Mailing Address
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Address Line | 323 SENATE CT
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City | HERNDON
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State | VA
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Zip | 20170-5488
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Country | US
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Telephone | 703-463-8847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 0007746
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | PA.0007746
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License Number State | CO
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