Provider Demographics
NPI:1457627523
Name:PRICE, JEANINE RAE (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:RAE
Last Name:PRICE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 W FM 120
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1549
Mailing Address - Country:US
Mailing Address - Phone:903-463-3033
Mailing Address - Fax:
Practice Address - Street 1:3405 W FM 120
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-1549
Practice Address - Country:US
Practice Address - Phone:903-463-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH059248-23363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health