Provider Demographics
NPI:1316072101
Name:HEPP, JENNIFER K (DO)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:K
Last Name:HEPP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10455 PARK MEADOWS DR
Mailing Address - Street 2:UNIT 102
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5599
Mailing Address - Country:US
Mailing Address - Phone:303-708-0246
Mailing Address - Fax:303-708-0247
Practice Address - Street 1:10455 PARK MEADOWS DR
Practice Address - Street 2:UNIT 102
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5599
Practice Address - Country:US
Practice Address - Phone:303-708-0246
Practice Address - Fax:303-708-0247
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COH29254Medicare UPIN