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General NPI Number Information
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NPI Number | 1912765777
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Entity Type | Individual
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Provider Name | JENNIFER MEADOWS FNP
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Gender | Female
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 15021 W BELL RD STE 125
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City | SURPRISE
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State | AZ
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Zip | 85374-3916
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Country | US
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Telephone | 949-642-5513
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3203
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 308446
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License Number State | AZ
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