Provider Demographics
NPI:1205819612
Name:SCHMOKER, JENNIFER (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SCHMOKER
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 1:3805 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-7322
Mailing Address - Country:US
Mailing Address - Phone:806-789-0608
Mailing Address - Fax:
Practice Address - Street 1:17191 ST LUKES WAY
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-8042
Practice Address - Country:US
Practice Address - Phone:936-273-2016
Practice Address - Fax:936-273-2018
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110508363LF0000X
TX608569363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP73823Medicare UPIN
TX88273HMedicare ID - Type Unspecified