Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Michelle Divine, MD

Individual provider MOHS-Micrographic Surgery Physician · NPI 1063779072

Jennifer Michelle Divine, MD is a Dermatology in Fort Collins, Colorado. Graduated from University of South Florida College of Medicine in 2012, 14 years ago. Practices with Divine Dermatology and Surgical Institute PLLC, a 5-clinician group and accepts Medicare assignment. Licensed in Colorado and Florida.

Years since qualifying
14
Trained at
University of South Florida College of Medicine
Licensed in
CO, FL
In the registry since
2012
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1260 Doctor's Ln
Fort Collins, CO 80524
Phone: (970) 286-2668
Fax: (970) 294-4954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence DR.0058205 (CO)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence ME 131766 (FL)

Record details

NPI number1063779072
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 15, 2012
Last updated in NPPESJuly 19, 2024
Certification dateJuly 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Also practisesMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Medical schoolUNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduated 2012 (14 years in practice)
Group practice Divine Dermatology And Surgical Institute Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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