Provider Demographics
NPI:1689840233
Name:GREENFIELD, JENNA GRIGGS (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:GRIGGS
Last Name:GREENFIELD
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 1:643 ASPEN RD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-9476
Mailing Address - Country:US
Mailing Address - Phone:303-955-7418
Mailing Address - Fax:
Practice Address - Street 1:3805 SIMMS ST
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-3871
Practice Address - Country:US
Practice Address - Phone:619-851-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99420208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics