Healthcare Provider Details

I. General information

NPI: 1801611785
Provider Name (Legal Business Name): JENNIFER RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 SARATOGA BLVD
CORPUS CHRISTI TX
78414-4100
US

IV. Provider business mailing address

3602 TOPEKA ST
CORPUS CHRISTI TX
78411-1718
US

V. Phone/Fax

Practice location:
  • Phone: 361-694-1660
  • Fax:
Mailing address:
  • Phone: 361-658-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1180041
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: