Individual
JENNELL ANNETTE KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
11245 HURON ST, WESTMINSTER, CO 80234-2806
(303) 338-4545
Mailing address
11245 HURON ST, WESTMINSTER, CO 80234-2806
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47146
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021969
KAISER COMMERCIAL NUMBER
CO
05
—
73985589
—
CO
Enumeration date
11/11/2008
Last updated
01/03/2012
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