Provider Demographics
NPI:1033995360
Name:URCH, JENNIFER MELINDA (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MELINDA
Last Name:URCH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27555 YNEZ RD STE 102
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4677
Mailing Address - Country:US
Mailing Address - Phone:951-302-2526
Mailing Address - Fax:
Practice Address - Street 1:27555 YNEZ RD STE 102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4677
Practice Address - Country:US
Practice Address - Phone:951-302-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027141363LF0000X
CA95088181163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency