Provider Demographics
NPI:1497882443
Name:JEWETT, CHRISTINE A (RN)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:A
Last Name:JEWETT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10065 E HARVARD AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5941
Mailing Address - Country:US
Mailing Address - Phone:303-614-1132
Mailing Address - Fax:
Practice Address - Street 1:10065 E HARVARD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5968
Practice Address - Country:US
Practice Address - Phone:303-614-1132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO73525208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
009014OtherKAISER-COMMERCIAL NUMBER