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NPI Code Detail

MEDICARE: MRS. JENNIFER LYNN PEREZ FNP-BC

MEDICARE: MRS. JENNIFER LYNN PEREZ 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 PractitionerAP135680TX

General Provider Information

NPI Number : 1396258612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LYNN PEREZ FNP-BC
Provider Business Mailing Address
First Line : 7704 MAHONIA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-7928
Country : US
Telephone Number : 817-991-6838
Fax Number :
Provider Business Practice Location Address
First Line : 201 S OAKRIDGE DR
Second Line :
City : HUDSON OAKS
State : TX
Zip : 76087-1793
Country : US
Telephone Number : 817-599-5518
Fax Number : 817-599-5538
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2017
Last Update Date : 11/08/2017

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Directions to “ MRS. JENNIFER LYNN PEREZ FNP-BC” Practice Location

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