Provider Demographics
NPI:1508642034
Name:DRIVER, JENN
Entity type:Individual
Prefix:
First Name:JENN
Middle Name:
Last Name:DRIVER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E MAIN ST STE 400
Mailing Address - Street 2:OFC 5490
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715
Mailing Address - Country:US
Mailing Address - Phone:214-918-3748
Mailing Address - Fax:
Practice Address - Street 1:233 E MAIN ST STE 400
Practice Address - Street 2:OFC 5490
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:214-918-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program