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NPI Code Detail

MEDICARE: MRS. LYNNETTE JEWEL CARRENS WHNP

MEDICARE: MRS. LYNNETTE JEWEL CARRENS WHNP
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
1363LX0001XObstetrics & Gynecology Nurse PractitionerTX
2363LW0102XWomen's Health Nurse PractitionerTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1R56311OTHERNMCERTIFIED NURSE PRACTITIO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386603207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNNETTE JEWEL CARRENS WHNP
Provider Business Mailing Address
First Line : 405 N TOM GREEN AVE
Second Line :
City : ODESSA
State : TX
Zip : 79761-5145
Country : US
Telephone Number : 432-580-9876
Fax Number : 432-580-9877
Provider Business Practice Location Address
First Line : 405 N TOM GREEN AVE
Second Line :
City : ODESSA
State : TX
Zip : 79761-5145
Country : US
Telephone Number : 432-580-9876
Fax Number : 432-580-9877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 09/11/2025

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