Provider Demographics
NPI:1982023404
Name:GARBE, JENEEN
Entity Type:Individual
Prefix:
First Name:JENEEN
Middle Name:
Last Name:GARBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENEEN
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:215 6TH ST
Mailing Address - Street 2:
Mailing Address - City:HOTCHKISS
Mailing Address - State:CO
Mailing Address - Zip Code:81419
Mailing Address - Country:US
Mailing Address - Phone:970-872-2623
Mailing Address - Fax:
Practice Address - Street 1:215 6TH ST
Practice Address - Street 2:
Practice Address - City:HOTCHKISS
Practice Address - State:CO
Practice Address - Zip Code:81419
Practice Address - Country:US
Practice Address - Phone:970-872-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-11
Last Update Date:2014-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist