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General NPI Number Information
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NPI Number | 1972367860
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Entity Type | Individual
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Provider Name | JENNIFER DAWN COMITO AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3333 COLORADO BLVD
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City | DENTON
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State | TX
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Zip | 76210-6817
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Country | US
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Telephone | 469-800-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 WHIPPOORWILL CT
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City | AZLE
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State | TX
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Zip | 76020-4539
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Country | US
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Telephone | 682-327-7273
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1141445
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License Number State | TX
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