Provider Demographics
NPI:1336391978
Name:GATHRIGHT, JENNIFER ANNE (AUD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ANNE
Last Name:GATHRIGHT
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ANNE
Other - Last Name:COCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1325 DRY CREEK DRIVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503
Mailing Address - Country:US
Mailing Address - Phone:720-494-9111
Mailing Address - Fax:
Practice Address - Street 1:4803 WARD RD
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80503-7732
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO540237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
540OtherCOLORADO LICENSE
CO020718OtherKAISER COMMERCIAL NUMBER
CO98433351Medicaid
COCO307392Medicare PIN