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NPI Code Detail

MEDICARE: JENNIFER HEWITT PMHNP

MEDICARE: JENNIFER HEWITT PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner256714AZ

General Provider Information

NPI Number : 1669053161
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HEWITT PMHNP
Provider Business Mailing Address
First Line : 103 W LEROUX ST
Second Line :
City : PRESCOTT
State : AZ
Zip : 86303-4213
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 505 S CORTEZ ST
Second Line :
City : PRESCOTT
State : AZ
Zip : 86303-4319
Country : US
Telephone Number : 928-445-5211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2021
Last Update Date : 04/16/2021

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