Provider Demographics
NPI:1891097804
Name:BARR, JENNIFER (RM, CPM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BARR
Suffix:
Gender:F
Credentials:RM, CPM
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 189
Mailing Address - Street 2:
Mailing Address - City:SNOWMASS
Mailing Address - State:CO
Mailing Address - Zip Code:81654-0189
Mailing Address - Country:US
Mailing Address - Phone:970-923-9213
Mailing Address - Fax:
Practice Address - Street 1:235 WILDCAT WAY
Practice Address - Street 2:
Practice Address - City:SNOWMASS
Practice Address - State:CO
Practice Address - Zip Code:81654
Practice Address - Country:US
Practice Address - Phone:970-923-9213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO120176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife