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Individual

JENNIFER BUCKLEY LANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1905 BLAKE AVE, SUITE 101, GLENWOOD SPRINGS, CO 81601-4288
(970) 945-2840
(970) 945-2893
Mailing address
1905 BLAKE AVE, SUITE 101, GLENWOOD SPRINGS, CO 81601-4288
(970) 945-2840
(970) 945-2893

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0109819
CO
176B00000X
Midwife
0001726
CO
363LF0000X
Family Nurse Practitioner
Primary
0003241
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07109812
CO
Enumeration date
03/21/2007
Last updated
12/22/2015
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