Provider Demographics
NPI:1275923633
Name:ANDRADE, JENNIFER LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 KIPLING ST UNIT 130
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2897
Mailing Address - Country:US
Mailing Address - Phone:720-688-6372
Mailing Address - Fax:720-815-2569
Practice Address - Street 1:4251 KIPLING ST UNIT 130
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2897
Practice Address - Country:US
Practice Address - Phone:720-688-6372
Practice Address - Fax:720-815-2569
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor