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General NPI Number Information
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NPI Number | 1073946984
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Entity Type | Individual
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Provider Name | JENNIFER RUBIO GREDICEK NP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 500 N CAPITAL OF TEXAS HWY # 6
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City | AUSTIN
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State | TX
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Zip | 78746-3302
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Country | US
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Telephone | 855-481-8375
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Fax |
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Provider Business Mailing Address
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Address Line | 209 S CHURCH ST SUITE B
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City | LOCKHART
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State | TX
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Zip | 78644-2713
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Country | US
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Telephone | 512-376-2999
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Fax | 512-376-5562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 642100
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | AP124084
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP124084
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License Number State | TX
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