Provider Demographics
NPI:1497874051
Name:BROWN, JENNIFER LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:500 ELDORADO BLVD STE 6250
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3421
Mailing Address - Country:US
Mailing Address - Phone:303-272-0768
Mailing Address - Fax:303-318-2488
Practice Address - Street 1:1960 OGDEN ST STE 460
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3670
Practice Address - Country:US
Practice Address - Phone:303-318-2500
Practice Address - Fax:303-318-2575
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN-105765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71700846Medicaid
CO71700846Medicaid