MEDICARE: JENNA TABATCHNICK

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	374J00000X	Doula

General Provider Information

NPI Number	:	1538892237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNA TABATCHNICK

Provider Business Mailing Address
First Line	:	3249 W FAIRVIEW PL APT 206
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5413
Country	:	US
Telephone Number	:	954-604-4548
Fax Number	:

Provider Business Practice Location Address
First Line	:	3249 W FAIRVIEW PL APT 206
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-5413
Country	:	US
Telephone Number	:	954-604-4548
Fax Number	:

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

Provider Enumeration Date	:	07/08/2022
Last Update Date	:	07/08/2022

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Directions to “ JENNA TABATCHNICK ” Practice Location

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