Provider Demographics
NPI:1104128537
Name:WULFEKUHLER, JESSICA PERZ (NP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:PERZ
Last Name:WULFEKUHLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 N HIGH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-5504
Mailing Address - Country:US
Mailing Address - Phone:303-301-9019
Mailing Address - Fax:303-861-6254
Practice Address - Street 1:2055 N HIGH ST STE 110
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5504
Practice Address - Country:US
Practice Address - Phone:303-301-9019
Practice Address - Fax:303-861-6254
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994994-NP363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000179925Medicaid