Most Relevant Information
Provider Data
| NPI Number: | 1003368150 |
| Provider Name: | JENNIFER MACK |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | APN.0992162-NP |
Most Important Dates
| Enumeration Date: | 10/25/2016 |
| Last Updated: | 10/25/2016 |
Provider Practice Location
6179 S BALSAM WAY STE 205
LITTLETON
CO
801233093
Practice Location Phone/Fax
| Phone: | 7207711135 |
| Fax: |
Provider Mailing Location
9249 S BROADWAY # 200-268
HIGHLANDS RANCH
CO
801295690
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |