Provider Demographics
NPI:1104049816
Name:RHODES, JENNIFER M (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 WARREN ST
Mailing Address - Street 2:APT A1D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6083
Mailing Address - Country:US
Mailing Address - Phone:718-858-7267
Mailing Address - Fax:
Practice Address - Street 1:595 CANYON BLVD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5230
Practice Address - Country:US
Practice Address - Phone:917-494-1190
Practice Address - Fax:414-346-7631
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO00613552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry