Provider Demographics
NPI:1588181648
Name:NUFFER, JAKE ROBERT (AUD)
Entity Type:Individual
Prefix:DR
First Name:JAKE
Middle Name:ROBERT
Last Name:NUFFER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9397 CROWN CREST BLVD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138
Mailing Address - Country:US
Mailing Address - Phone:720-842-1890
Mailing Address - Fax:303-840-9617
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:SUITE 307
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138
Practice Address - Country:US
Practice Address - Phone:720-842-1890
Practice Address - Fax:303-840-9617
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO869231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist