Provider Demographics
NPI:1962659789
Name:VANESSEN, JENNIFER ANNE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:VANESSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 FILLMORE ST
Mailing Address - Street 2:#301
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4358
Mailing Address - Country:US
Mailing Address - Phone:303-523-6111
Mailing Address - Fax:
Practice Address - Street 1:345 FILLMORE ST
Practice Address - Street 2:#301
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4358
Practice Address - Country:US
Practice Address - Phone:303-523-6111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO163404163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse