Provider Demographics
NPI:1932560844
Name:JAFFE, JODY (CNM)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:JAFFE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:JAFFE-LIPSITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7155 E 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-1630
Mailing Address - Country:US
Mailing Address - Phone:303-321-7625
Mailing Address - Fax:303-861-0268
Practice Address - Street 1:7735 WADSWORTH BLVD
Practice Address - Street 2:#D/24
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2143
Practice Address - Country:US
Practice Address - Phone:303-467-3766
Practice Address - Fax:303-425-6101
Is Sole Proprietor?:No
Enumeration Date:2016-03-19
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0069860163W00000X
COAPN.0000310-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23406844Medicaid