Provider Demographics
NPI:1568731578
Name:THORPE-MCCOVERY, JENNIFER THERESA (CNM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:THERESA
Last Name:THORPE-MCCOVERY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18220 STATE HIGHWAY 249 STE 370
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4349
Mailing Address - Country:US
Mailing Address - Phone:346-208-8653
Mailing Address - Fax:
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 370
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4349
Practice Address - Country:US
Practice Address - Phone:832-698-5515
Practice Address - Fax:832-698-5516
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024187992367A00000X
TXAP929134367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ916331Medicaid