Provider Demographics
NPI:1578017869
Name:O'BRIEN, JENNA (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15821 SPILLMAN RANCH LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6573
Mailing Address - Country:US
Mailing Address - Phone:717-319-1123
Mailing Address - Fax:
Practice Address - Street 1:4201 BEE CAVES RD STE B200
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6458
Practice Address - Country:US
Practice Address - Phone:512-478-9845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily