Provider Demographics
NPI:1508008673
Name:WARD, JENNIFER RUE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RUE
Last Name:WARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1875
Mailing Address - Street 2:433 SIXTH ST.
Mailing Address - City:CRESTED BUTTE
Mailing Address - State:CO
Mailing Address - Zip Code:81224-3715
Mailing Address - Country:US
Mailing Address - Phone:970-964-8472
Mailing Address - Fax:
Practice Address - Street 1:433 SIXTH STREET
Practice Address - Street 2:
Practice Address - City:CRESTED BUTTE
Practice Address - State:CO
Practice Address - Zip Code:81224-3715
Practice Address - Country:US
Practice Address - Phone:970-964-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine