Provider Demographics
NPI:1043762768
Name:VERMETTE, JENNIFER TERUKO (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:TERUKO
Last Name:VERMETTE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:TERUKO
Other - Last Name:FEWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:8505 183RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-9354
Mailing Address - Country:US
Mailing Address - Phone:815-824-4406
Mailing Address - Fax:
Practice Address - Street 1:8505 183RD ST STE A
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-9354
Practice Address - Country:US
Practice Address - Phone:815-824-4406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily