Provider Demographics
NPI:1225695562
Name:SHURER, JENNA ROSE (FNP)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:ROSE
Last Name:SHURER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:ROSE
Other - Last Name:TITKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5030 CAMINO DE LA SIESLA STE 106
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-692-4401
Mailing Address - Fax:619-692-8147
Practice Address - Street 1:5030 CAMINO DE LA SIESLA STE 106
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-692-4401
Practice Address - Fax:619-692-8147
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily