MEDICARE: JANICE I. JARRETT

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	152W00000X	Optometrist	1310	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811978869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE I. JARRETT

Provider Business Mailing Address
First Line	:	1336 LEYDEN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2805
Country	:	US
Telephone Number	:	303-333-9898
Fax Number	:	303-333-0719

Provider Business Practice Location Address
First Line	:	1336 LEYDEN ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2805
Country	:	US
Telephone Number	:	303-333-9898
Fax Number	:	303-333-0719

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	06/01/2011

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