Provider Demographics
NPI:1174851182
Name:WERT, JENNIFER (CD (DONA))
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WERT
Suffix:
Gender:F
Credentials:CD (DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80306-0058
Mailing Address - Country:US
Mailing Address - Phone:303-829-0874
Mailing Address - Fax:
Practice Address - Street 1:535 NORTHSTAR CT
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1087
Practice Address - Country:US
Practice Address - Phone:303-829-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula