Healthcare Provider Details

I. General information

NPI: 1093640799
Provider Name (Legal Business Name): JENNY LYNN WOODCOCK FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNY LYNN ABRAHAM FNP-C

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12419 DORSETT RD
AUSTIN TX
78727-5807
US

IV. Provider business mailing address

12419 DORSETT RD
AUSTIN TX
78727-5807
US

V. Phone/Fax

Practice location:
  • Phone: 512-922-0819
  • Fax:
Mailing address:
  • Phone: 512-922-0819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1224294
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: