Provider Demographics
NPI:1477938918
Name:ALLEN, JENNA LYNN (RD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 TANAGER CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-2697
Mailing Address - Country:US
Mailing Address - Phone:303-517-2764
Mailing Address - Fax:
Practice Address - Street 1:1600 PRAIRIE CENTER PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4006
Practice Address - Country:US
Practice Address - Phone:303-498-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered