MEDICARE: JESSIE FARRIS

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	174N00000X	Lactation Consultant (Non-RN)		CO

General Provider Information

NPI Number	:	1538006366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSIE FARRIS

Provider Business Mailing Address
First Line	:	2243 HOOKER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5042
Country	:	US
Telephone Number	:	605-484-8385
Fax Number	:

Provider Business Practice Location Address
First Line	:	2243 HOOKER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5042
Country	:	US
Telephone Number	:	605-484-8385
Fax Number	:

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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Directions to “ JESSIE FARRIS ” Practice Location

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