Healthcare Provider Details

I. General information

NPI: 1710666821
Provider Name (Legal Business Name): JENNIFER ATKINSON APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 BERNARD ST
LA PORTE TX
77571-3827
US

IV. Provider business mailing address

3305 BERNARD ST
LA PORTE TX
77571-3827
US

V. Phone/Fax

Practice location:
  • Phone: 832-887-6546
  • Fax:
Mailing address:
  • Phone: 832-887-6546
  • Fax: 281-938-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1128330
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: