Provider Demographics
NPI:1376843623
Name:FIGHTMASTER, JENNIFER SUE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:FIGHTMASTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16230 E 106TH WAY
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-8809
Mailing Address - Country:US
Mailing Address - Phone:303-594-1230
Mailing Address - Fax:
Practice Address - Street 1:1017 E SOUTH BOULDER RD STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2547
Practice Address - Country:US
Practice Address - Phone:036-667-7173
Practice Address - Fax:036-667-7463
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO178571163WM0705X
CO99015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COMF3018822OtherDEA