Individual
GREGORY MICHAEL JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
8444 SUMMERLIN DR, LONGMONT, CO 80503-3906
(720) 577-5251
(720) 780-7057
Mailing address
1120 SHACKELFORD RD, FLORISSANT, MO 63031-4369
(314) 830-5805
(314) 830-5806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2018003488
MO
363LF0000X
Family Nurse Practitioner
Primary
209017407
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209017407
—
IL
Enumeration date
03/29/2018
Last updated
06/30/2022
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