Provider Demographics
NPI:1790310712
Name:HARKINS, JEANNE MARIE
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:HARKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-4408
Mailing Address - Country:US
Mailing Address - Phone:815-558-3078
Mailing Address - Fax:
Practice Address - Street 1:11920 W 13TH AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-4408
Practice Address - Country:US
Practice Address - Phone:815-558-3078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO373H00000X, 251C00000X, 347C00000X, 103TM1800X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate Vehicle
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)