Provider Demographics
NPI:1023759651
Name:MANN, JENNIFER LYNNE (RN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LYNNE
Last Name:MANN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ROWAN
Other - Middle Name:LYNNE
Other - Last Name:MANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:7804 ROBINSON WAY
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-5549
Mailing Address - Country:US
Mailing Address - Phone:734-417-9854
Mailing Address - Fax:
Practice Address - Street 1:6162 S WILLOW DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5113
Practice Address - Country:US
Practice Address - Phone:303-220-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1628125163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse