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NPI Code Detail

MEDICARE: JENNA FENTON

MEDICARE: JENNA FENTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorNLC.0110148CO

General Provider Information

NPI Number : 1083262794
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA FENTON
Provider Business Mailing Address
First Line : 11681 VOYAGER PKWY STE 150
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3864
Country : US
Telephone Number : 719-344-9342
Fax Number :
Provider Business Practice Location Address
First Line : 11681 VOYAGER PKWY STE 150
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-3864
Country : US
Telephone Number : 719-344-9342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2019
Last Update Date : 08/27/2019

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Directions to “ JENNA FENTON ” Practice Location

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