Provider Demographics
NPI:1275125478
Name:RAZIS, JENNIFER RALYN (APRN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RALYN
Last Name:RAZIS
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 DON DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8657
Mailing Address - Country:US
Mailing Address - Phone:214-345-2653
Mailing Address - Fax:972-262-1109
Practice Address - Street 1:4405 DON DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8657
Practice Address - Country:US
Practice Address - Phone:214-345-2653
Practice Address - Fax:972-262-1109
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143409176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty