Basic Information
| Provider Information | |||||||||
| NPI: | 1033545009 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ATTEBERY | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ACNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2695 ROCKY MOUNTAIN AVE STE CB8054 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805388702 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 BARNES JEWISH HOSPITAL PLZ | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631101003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3143626973 | ||||||||
| FaxNumber: | 3143621185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2013 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | APN.0996167-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | 112678 | NE | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LA2100X | APN.0996167-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | 2013039402 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 1033545009 | 05 | MO | MEDICAID |