Provider Demographics
NPI:1417567363
Name:JOLLIFFE, JENNIE RENEE (RN MSN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIE
Middle Name:RENEE
Last Name:JOLLIFFE
Suffix:
Gender:F
Credentials:RN MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17424 COUNTY ROAD 30.5
Mailing Address - Street 2:
Mailing Address - City:STRATTON
Mailing Address - State:CO
Mailing Address - Zip Code:80836-8808
Mailing Address - Country:US
Mailing Address - Phone:970-302-0842
Mailing Address - Fax:
Practice Address - Street 1:111 6TH ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-2002
Practice Address - Country:US
Practice Address - Phone:719-743-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0995752363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily