Provider Demographics
NPI:1407105216
Name:FARMER, JENNIFER RYAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:RYAN
Last Name:FARMER
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 1:7011 RIBELIN RANCH DRIVE
Mailing Address - Street 2:STE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8585
Mailing Address - Country:US
Mailing Address - Phone:512-345-7436
Mailing Address - Fax:512-346-7436
Practice Address - Street 1:7011 RIBELIN RANCH DRIVE
Practice Address - Street 2:STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-8585
Practice Address - Country:US
Practice Address - Phone:512-345-7436
Practice Address - Fax:512-346-7436
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily