Individual
MRS. JENNIFER RYAN BLACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2001 S SHIELDS ST, BUILDING I, FORT COLLINS, CO 80526-1827
(970) 221-5255
(970) 221-5206
Mailing address
2001 S SHIELDS ST, BUILDING I, FORT COLLINS, CO 80526-1827
(970) 221-5255
(970) 221-5206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0812
SD
363A00000X
Physician Assistant
Primary
2546
CO
363A00000X
Physician Assistant
PA-795
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807782300
—
ID
Enumeration date
01/30/2008
Last updated
07/18/2016
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