MEDICARE: JESSICA BUCKINGHAM

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	251X00000X	Supports Brokerage Agency		CO

General Provider Information

NPI Number	:	1750240024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BUCKINGHAM

Provider Business Mailing Address
First Line	:	1820 APPLEWOOD DR
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-2522
Country	:	US
Telephone Number	:	303-834-7163
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 APPLEWOOD DR
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-2522
Country	:	US
Telephone Number	:	303-834-7163
Fax Number	:

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

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “ JESSICA BUCKINGHAM ” Practice Location

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