Provider Demographics
NPI:1457597445
Name:HART, JENNIFER LYNN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:HART
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:333 W HAMPDEN AVE
Mailing Address - Street 2:STE 600
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2336
Mailing Address - Country:US
Mailing Address - Phone:970-224-2985
Mailing Address - Fax:970-472-9381
Practice Address - Street 1:1236 E ELIZABETH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4000
Practice Address - Country:US
Practice Address - Phone:970-224-2985
Practice Address - Fax:970-472-9381
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2022-12-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0025004367500000X
FLAPRN11021722367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO26682842Medicaid
COP01222773OtherRR MEDICARE
CO26682842Medicaid