Healthcare Provider Details

I. General information

NPI: 1700427671
Provider Name (Legal Business Name): JENNIFER REYNOLDS MENSER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER YOUNG REYNOLDS

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2633 16TH ST
BAKERSFIELD CA
93301-3348
US

IV. Provider business mailing address

2633 16TH ST
BAKERSFIELD CA
93301-3348
US

V. Phone/Fax

Practice location:
  • Phone: 661-634-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95012013
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: