Provider Demographics
NPI:1699304667
Name:JENNIFER R MOONEY, MSN, APRN-C, LLC
Entity type:Organization
Organization Name:JENNIFER R MOONEY, MSN, APRN-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-C
Authorized Official - Phone:785-564-0746
Mailing Address - Street 1:3955 E EXPOSITION AVE STE 316
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-5032
Mailing Address - Country:US
Mailing Address - Phone:720-664-8020
Mailing Address - Fax:303-552-5720
Practice Address - Street 1:3955 E EXPOSITION AVE STE 316
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5032
Practice Address - Country:US
Practice Address - Phone:720-664-8020
Practice Address - Fax:303-552-5720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1952498891OtherNPI