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NPI Code Detail

MEDICARE: JENNIFER LYNNE PERREAULT

MEDICARE:   JENNIFER LYNNE PERREAULT
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
1363LF0000XFamily Nurse PractitionerAPN.1001908-NPCO

General Provider Information

NPI Number : 1952247413
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNNE PERREAULT
Provider Business Mailing Address
First Line : 5364 FREEBOOT PT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80922-3279
Country : US
Telephone Number : 719-200-8585
Fax Number :
Provider Business Practice Location Address
First Line : 5364 FREEBOOT PT
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80922-3279
Country : US
Telephone Number : 719-200-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 04/27/2026

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Directions to “ JENNIFER LYNNE PERREAULT ” Practice Location

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