Provider Demographics
NPI:1689437402
Name:KNOTWELL, JENNIFER HAWLEY (IBCLC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HAWLEY
Last Name:KNOTWELL
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4734 S TAFT CT
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-1944
Mailing Address - Country:US
Mailing Address - Phone:970-846-8679
Mailing Address - Fax:
Practice Address - Street 1:4734 S TAFT CT
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:CO
Practice Address - Zip Code:80465-1944
Practice Address - Country:US
Practice Address - Phone:970-846-8679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COL-314497174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN