Individual
TARA JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3702 S TIMBERLINE RD, BLDG A, FORT COLLINS, CO 80525-3624
(970) 212-0879
(970) 484-8667
Mailing address
3702 S TIMBERLINE RD, BLDG A, FORT COLLINS, CO 80525-3624
(970) 212-0879
(970) 484-8667
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306752
NY
363LG0600X
Gerontology Nurse Practitioner
0992029
CO
363LG0600X
Gerontology Nurse Practitioner
340927
NY
Other
Enumeration date
12/17/2013
Last updated
09/22/2021
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