Individual
JENNIFER V ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3433 WARREN FARM DR, FORT COLLINS, CO 80526-6344
(651) 319-1563
Mailing address
3433 WARREN FARM DR, FORT COLLINS, CO 80526-6344
(651) 319-1563
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0004068
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10237259
—
CO
Enumeration date
11/11/2014
Last updated
07/07/2015
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