Individual
DR. JENNIFER R LYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 BANNOCK ST, DENVER, CO 80204-4597
(303) 436-4949
(303) 602-5056
Mailing address
777 BANNOCK ST, DENVER, CO 80204-4597
(303) 436-4949
(303) 602-5056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60279754
WA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
DR.0057208
CO
208M00000X
Hospitalist Physician
Primary
DR.0057208
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293916
L&I
WA
05
—
1205099173
—
WA
Enumeration date
07/09/2008
Last updated
12/31/2024
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