Provider Demographics
NPI:1326036229
Name:BAXTER, JENNIFER R (MSN CNM)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:R
Last Name:BAXTER
Suffix:
Gender:F
Credentials:MSN CNM
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-320-2944
Mailing Address - Fax:303-320-2947
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3910
Practice Address - Country:US
Practice Address - Phone:303-320-2944
Practice Address - Fax:303-320-2947
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2014-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO3683367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85153371Medicaid
COCO306341Medicare PIN
CO811128Medicare PIN
COC810753Medicare PIN
CO85153371Medicaid