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NPI Code Detail

MEDICARE: JENNIFER L. LAKOWSKY-BRUECKNER FNP

MEDICARE: JENNIFER L. LAKOWSKY-BRUECKNER FNP
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 PractitionerAP113869TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18N9280OTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548245004
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L. LAKOWSKY-BRUECKNER FNP
Provider Business Mailing Address
First Line : 5402 WESTHEIMER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77056-5302
Country : US
Telephone Number : 713-540-7909
Fax Number :
Provider Business Practice Location Address
First Line : 5402 WESTHEIMER RD
Second Line :
City : HOUSTON
State : TX
Zip : 77056-5302
Country : US
Telephone Number : 713-540-7909
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 10/27/2022

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