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NPI Code Detail

MEDICARE: JENNIFER KOLLER WHNP

MEDICARE: JENNIFER KOLLER WHNP
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
1363LW0102XWomen's Health Nurse PractitionerAP132034TX

General Provider Information

NPI Number : 1942759675
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KOLLER WHNP
Provider Business Mailing Address
First Line : 4600 SCYENE RD
Second Line :
City : DALLAS
State : TX
Zip : 75210-2219
Country : US
Telephone Number : 214-266-1000
Fax Number :
Provider Business Practice Location Address
First Line : 4600 SCYENE RD
Second Line :
City : DALLAS
State : TX
Zip : 75210-2219
Country : US
Telephone Number : 214-266-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2016
Last Update Date : 09/22/2016

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