Provider Demographics
NPI:1104140698
Name:BAJADALI, JENNIFER KAREN (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KAREN
Last Name:BAJADALI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-4115
Mailing Address - Country:US
Mailing Address - Phone:303-282-8053
Mailing Address - Fax:
Practice Address - Street 1:2800 EXEMPLA CIRCLE
Practice Address - Street 2:
Practice Address - City:LAYFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026
Practice Address - Country:US
Practice Address - Phone:720-536-7055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO118341163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse