Individual
JENNIFER RENEE SEDERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 398-1211
Mailing address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 398-1211
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APN.0991749-NP
CO
363LG0600X
Gerontology Nurse Practitioner
APN.0991749-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02750058
—
CO
05
—
1134507106
—
CO
01
—
438668YLSH
MEDICARE PTAN
CO
01
—
APN.0991749-NP
APN LICENSE
CO
01
—
RN.0179429
RN LICENSE
CO
Enumeration date
05/11/2015
Last updated
03/17/2021
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