Provider Demographics
NPI:1134399256
Name:DOSSETT, JENNIFER DAVIS (RM)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAVIS
Last Name:DOSSETT
Suffix:
Gender:F
Credentials:RM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3573 IVY CIR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-1908
Mailing Address - Country:US
Mailing Address - Phone:720-271-7460
Mailing Address - Fax:
Practice Address - Street 1:5377 MANHATTAN CIR
Practice Address - Street 2:SUITE 200
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4333
Practice Address - Country:US
Practice Address - Phone:720-271-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay