Provider Demographics
NPI:1033347786
Name:YEAGER, JENNIFER (RN CP NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:YEAGER
Suffix:
Gender:F
Credentials:RN CP NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 W WADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5055
Mailing Address - Country:US
Mailing Address - Phone:432-699-2636
Mailing Address - Fax:432-699-4134
Practice Address - Street 1:5801 W WADLEY AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5055
Practice Address - Country:US
Practice Address - Phone:432-699-2636
Practice Address - Fax:432-699-4134
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX715547363LP0200X
TXAP116811363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics