Provider Demographics
NPI:1083252001
Name:JAMES, JACQUELINE BARNETT (LAC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:BARNETT
Last Name:JAMES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 CROWN VIEW DR UNIT 5
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5881
Mailing Address - Country:US
Mailing Address - Phone:406-595-6191
Mailing Address - Fax:
Practice Address - Street 1:2473 CROWN VIEW DR UNIT 5
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5881
Practice Address - Country:US
Practice Address - Phone:406-595-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-20
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-ACU-LIC-61070171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist