Provider Demographics
NPI:1528729332
Name:SENNETT, JENELL LARAE (CPHT)
Entity type:Individual
Prefix:
First Name:JENELL
Middle Name:LARAE
Last Name:SENNETT
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17043 GOLDEN POPPY LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4395
Mailing Address - Country:US
Mailing Address - Phone:707-685-0019
Mailing Address - Fax:
Practice Address - Street 1:9395 CROWN CREST BLVD
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8573
Practice Address - Country:US
Practice Address - Phone:303-269-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002703183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician