Divine, Jennifer Michelle

Divine, Jennifer Michelle is an sole proprietor health care provider with primary practice located at 1260 Doctor'S Lane , Fort Collins CO 80524. She recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as her primary health care specialty. Divine, Jennifer Michelle can be contacted via phone (970) 286-2668.

Contact Information

Primary practice address
1260 Doctor'S Lane Fort Collins CO 80524
Phone: (970) 286-2668
Fax: (970) 294-4954
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X ME 131766 Florida
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X DR.0058205 Colorado

Profile Details

NPI number 1063779072
LBN Legal business name Divine, Jennifer Michelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 15th, 2012
Last updated Jul 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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