Provider Demographics
NPI:1356682405
Name:AUTEN, JENNIFER (CSFA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AUTEN
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2332 COUNTY ROAD 1076
Mailing Address - Street 2:
Mailing Address - City:CELESTE
Mailing Address - State:TX
Mailing Address - Zip Code:75423-5714
Mailing Address - Country:US
Mailing Address - Phone:817-401-1862
Mailing Address - Fax:
Practice Address - Street 1:2332 COUNTY ROAD 1076
Practice Address - Street 2:
Practice Address - City:CELESTE
Practice Address - State:TX
Practice Address - Zip Code:75423-5714
Practice Address - Country:US
Practice Address - Phone:817-401-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX139891246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant