Provider Demographics
NPI:1679238158
Name:JENNIFER BLUNTZER PLLC
Entity Type:Organization
Organization Name:JENNIFER BLUNTZER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:FOXELL
Authorized Official - Last Name:BLUNTZER
Authorized Official - Suffix:
Authorized Official - Credentials:AGACNP-BC
Authorized Official - Phone:361-649-5369
Mailing Address - Street 1:448 SENDERA LOOP
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-5325
Mailing Address - Country:US
Mailing Address - Phone:361-649-5369
Mailing Address - Fax:
Practice Address - Street 1:448 SENDERA LOOP
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-5325
Practice Address - Country:US
Practice Address - Phone:361-649-5369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty