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1083222897
JENNIFER DIANE LONGSHORE
COLORADO SPRINGS, CO
NPI
1083222897
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: CO 0995027)
Enumeration Date
2020-07-17
Last Update Date
2020-12-30
Business Address
JENNIFER DIANE LONGSHORE PNP- PC
6965 TUTT BLVD
COLORADO SPRINGS, CO 80923-3596
Phone number: 719-266-5944
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Mailing Address
JENNIFER DIANE LONGSHORE PNP- PC
4891 ECKERT ST
CASTLE ROCK, CO 80104-5430
Phone number: 903-806-4166
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