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General NPI Number Information
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NPI Number | 1609132349
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Entity Type | Individual
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Provider Name | JENNIFER LYNN KILLEBREW NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 28515 RR 12
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-3800
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Country | US
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Telephone | 512-673-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 28515 RR 12
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City | DRIPPING SPRINGS
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State | TX
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Zip | 78620-3800
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Country | US
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Telephone |
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Fax |
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 743268
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | AP122392
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License Number State | TX
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