Provider Demographics
NPI:1437735693
Name:HULS, JENNIFER LYNN (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HULS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1529
Mailing Address - Country:US
Mailing Address - Phone:505-766-5197
Mailing Address - Fax:505-766-6945
Practice Address - Street 1:NORTH VALLEY HEALTH CENTER
Practice Address - Street 2:1231 CANDELARIA RD NW
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107
Practice Address - Country:US
Practice Address - Phone:505-345-3244
Practice Address - Fax:505-766-6945
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF02201091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine