MEDICARE: JENNIFER MICHELLE BURNETT

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
1	251E00000X	Home Health Agency		CO

General Provider Information

NPI Number	:	1093641755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MICHELLE BURNETT

Provider Business Mailing Address
First Line	:	1521 TANG CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-9684
Country	:	US
Telephone Number	:	562-587-3617
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 TANG CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-9684
Country	:	US
Telephone Number	:	562-587-3617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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