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NPI Code Detail

MEDICARE: JENNA-MAREE INMAN FNP-BC

MEDICARE:   JENNA-MAREE  INMAN  FNP-BC
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
1363LF0000XFamily Nurse Practitioner698240TX

General Provider Information

NPI Number : 1215393533
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA-MAREE INMAN FNP-BC
Provider Business Mailing Address
First Line : 1273 S PEACHTREE ST
Second Line :
City : JASPER
State : TX
Zip : 75951-4915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1273 S PEACHTREE ST
Second Line :
City : JASPER
State : TX
Zip : 75951-4915
Country : US
Telephone Number : 409-384-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2016
Last Update Date : 01/04/2016

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Directions to “ JENNA-MAREE INMAN FNP-BC” Practice Location

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