Provider Demographics
NPI:1770830721
Name:JAMES, JENNIFER D (NP)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:D
Last Name:JAMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 E UNIVERSITY BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79762-8149
Mailing Address - Country:US
Mailing Address - Phone:432-362-4544
Mailing Address - Fax:
Practice Address - Street 1:5000 E UNIVERSITY BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-8149
Practice Address - Country:US
Practice Address - Phone:432-889-5525
Practice Address - Fax:432-362-4594
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122518363LP2300X
TX687003363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care