Provider Demographics
NPI:1154735827
Name:HARRISON, JENNIFER (FNP, BS, BSN, RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:FNP, BS, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 S TIMBERLINE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4334
Mailing Address - Country:US
Mailing Address - Phone:970-495-0506
Mailing Address - Fax:970-495-0485
Practice Address - Street 1:3744 S TIMBERLINE RD STE 102
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4334
Practice Address - Country:US
Practice Address - Phone:970-495-0506
Practice Address - Fax:970-049-5048
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily