MEDICARE: JENY K JOHN FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	ARNP9211403	FL
2	363LF0000X	Family Nurse Practitioner	1013542	TX

General Provider Information

NPI Number	:	1073019493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENY K JOHN FNP-C

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7545 SHORE ACRES ST
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4251
Country	:	US
Telephone Number	:	813-760-5369
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	09/15/2025

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