Provider Demographics
NPI:1043251515
Name:JONES, JENNIFER (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4209
Mailing Address - Country:US
Mailing Address - Phone:970-663-0135
Mailing Address - Fax:970-461-1422
Practice Address - Street 1:1813 CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4244
Practice Address - Country:US
Practice Address - Phone:970-203-6801
Practice Address - Fax:970-203-6821
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO90626363LX0001X
CONP-792363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03007545Medicaid
COCOA105327Medicare PIN