MEDICARE: JENNIFER HA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1010551	TX

General Provider Information

NPI Number	:	1568082709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HA

Provider Business Mailing Address
First Line	:	2201 SPINKS RD STE 135
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4499
Country	:	US
Telephone Number	:	469-444-7666
Fax Number	:	254-346-9043

Provider Business Practice Location Address
First Line	:	2201 SPINKS RD STE 135
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4499
Country	:	US
Telephone Number	:	469-444-7666
Fax Number	:	254-346-9043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	03/03/2026

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Directions to “ JENNIFER HA ” Practice Location

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