Provider Demographics
NPI:1073669602
Name:JANSSEN, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NATIONAL JEWISH HEALTH
Mailing Address - Street 2:1400 JACKSON STREET
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80262-0001
Mailing Address - Country:US
Mailing Address - Phone:303-388-4461
Mailing Address - Fax:303-270-2174
Practice Address - Street 1:NATIONAL JEWISH HEALTH
Practice Address - Street 2:1400 JACKSON STREET
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80262-0001
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:303-270-2174
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR-40796390200000X
CO40796207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43172237Medicaid
CO43172237Medicaid
COH36166Medicare UPIN