Provider Demographics
NPI:1316382922
Name:MAYS, JENNIFER N (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:N
Last Name:MAYS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GARRETT
Mailing Address - State:IN
Mailing Address - Zip Code:46738-1537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13821 LEO RD
Practice Address - Street 2:
Practice Address - City:LEO
Practice Address - State:IN
Practice Address - Zip Code:46765-9400
Practice Address - Country:US
Practice Address - Phone:260-553-0994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004461A363LF0000X
IN28188638A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily