Provider Demographics
NPI:1003801671
Name:COOPER, JENNIFER LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:14300 ORCHARD PKWY
Mailing Address - Street 2:FLOOR 3 POD 1
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9206
Mailing Address - Country:US
Mailing Address - Phone:303-426-2580
Mailing Address - Fax:303-426-2590
Practice Address - Street 1:14300 ORCHARD PKWY
Practice Address - Street 2:FLOOR 3 POD 1
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80023-9206
Practice Address - Country:US
Practice Address - Phone:303-426-2580
Practice Address - Fax:303-426-2590
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO43726207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40480780Medicaid
COC811747Medicare PIN