MEDICARE: MRS. JENNIFER GUIEN 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
1	363LF0000X	Family Nurse Practitioner	1044935	TX

General Provider Information

NPI Number	:	1760123996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER GUIEN FNP

Provider Business Mailing Address
First Line	:	23702 OAKDALE CLIFF CT
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-8118
Country	:	US
Telephone Number	:	832-457-6722
Fax Number	:

Provider Business Practice Location Address
First Line	:	23920 KATY FWY STE 200
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-0881
Country	:	US
Telephone Number	:	832-457-6722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2022
Last Update Date	:	04/03/2022

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