Provider Demographics
NPI:1114536166
Name:BLUNTZER, JENNIFER FOXELL (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FOXELL
Last Name:BLUNTZER
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 SENDERA LOOP
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-5325
Mailing Address - Country:US
Mailing Address - Phone:361-649-5369
Mailing Address - Fax:
Practice Address - Street 1:448 SENDERA LOOP
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-5325
Practice Address - Country:US
Practice Address - Phone:361-649-5369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1005217363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care