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NPI Code Detail

MEDICARE: JENNIFER KELLER KASER LVN

MEDICARE:   JENNIFER  KELLER KASER  LVN
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
1164X00000XLicensed Vocational Nurse302089TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1302089OTHERTXTBON

General Provider Information

NPI Number : 1629570098
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KELLER KASER LVN
Provider Business Mailing Address
First Line : 8722 CINNAMON CREEK DR APT 1162
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-4528
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8722 CINNAMON CREEK DR APT 1162
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-4528
Country : US
Telephone Number : 210-847-6243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2018
Last Update Date : 03/01/2018

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Directions to “ JENNIFER KELLER KASER LVN” Practice Location

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