Healthcare Provider Details

I. General information

NPI: 1245726447
Provider Name (Legal Business Name): JENNIFER RENEE SCHAFER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2018
Last Update Date: 02/19/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 BIA ROUTE 140
PINEHILL NM
87357-0240
US

IV. Provider business mailing address

81 CONEJO DR 873
RAMAH NM
87321
US

V. Phone/Fax

Practice location:
  • Phone: 505-775-3271
  • Fax: 505-775-3633
Mailing address:
  • Phone: 240-256-0158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number74299
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: