Provider Demographics
NPI:1043335656
Name:DHORITY, JEAN ALLYN (CPM)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ALLYN
Last Name:DHORITY
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 VERDOS DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:CO
Mailing Address - Zip Code:80107-8547
Mailing Address - Country:US
Mailing Address - Phone:303-646-1350
Mailing Address - Fax:303-646-1356
Practice Address - Street 1:555 VERDOS DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107-8547
Practice Address - Country:US
Practice Address - Phone:303-646-1350
Practice Address - Fax:303-646-1356
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3511257176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife