Healthcare Provider Details

I. General information

NPI: 1699297283
Provider Name (Legal Business Name): JENNIFER JALEEN SEARCY CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 2ND ST NW
ALBUQUERQUE NM
87107-6755
US

IV. Provider business mailing address

7704 2ND ST NW STE A
ALBUQUERQUE NM
87107-6755
US

V. Phone/Fax

Practice location:
  • Phone: 505-890-1458
  • Fax: 505-890-1599
Mailing address:
  • Phone: 505-890-1458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-03291
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: