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General NPI Number Information
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NPI Number | 1245570407
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Entity Type | Individual
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Provider Name | JENNIFER ANNE ISHMAEL MSN, CFNP
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Gender | Female
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 950 N 14TH ST STE 100
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City | BEAUMONT
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State | TX
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Zip | 77702-1112
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Country | US
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Telephone | 409-833-5858
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Fax | 409-833-1155
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Provider Business Mailing Address
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Address Line | 950 N 14TH ST SUITE 100
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City | BEAUMONT
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State | TX
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Zip | 77702-1111
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Country | US
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Telephone | 409-833-5858
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Fax | 409-833-1155
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 750272
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 750272
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License Number State | TX
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