Provider Demographics
NPI:1194440784
Name:MCDOWALL, JENNIFER LAUREN (RN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:MCDOWALL
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 1:2300 S ROCK CREEK PKWY APT 7-202
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4453
Mailing Address - Country:US
Mailing Address - Phone:321-223-4084
Mailing Address - Fax:
Practice Address - Street 1:2300 S ROCK CREEK PKWY APT 7-202
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-4453
Practice Address - Country:US
Practice Address - Phone:321-223-4084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN1661259163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse