MEDICARE: JENNIFER AMALIE VINH CNS

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	364SG0600X	Gerontology Clinical Nurse Specialist	0993452	CO
2	364SA2200X	Adult Health Clinical Nurse Specialist	APN.0993452-CNS	CO

General Provider Information

NPI Number	:	1598275109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER AMALIE VINH CNS

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12605 E 16TH AVE
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-2545
Country	:	US
Telephone Number	:	720-848-0000
Fax Number	:

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

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	09/23/2020

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