Provider Demographics
NPI:1619447406
Name:MERTEN, JENNIFER THERESE (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:THERESE
Last Name:MERTEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MARKETPLACE PLZ
Mailing Address - Street 2:STE 200
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-1841
Mailing Address - Country:US
Mailing Address - Phone:970-879-6663
Mailing Address - Fax:970-871-1234
Practice Address - Street 1:705 MARKETPLACE PLZ
Practice Address - Street 2:STE 200
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-1841
Practice Address - Country:US
Practice Address - Phone:970-879-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2018033942363LF0000X
CO2018033940363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology