Provider Demographics
NPI:1841392925
Name:STEINER, JENNIFER CAREY (PA C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CAREY
Last Name:STEINER
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CAREY
Other - Last Name:BOEDEKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13540 HEARTSIDE PLACE
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4821
Mailing Address - Country:US
Mailing Address - Phone:972-243-3811
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER
Practice Address - Street 2:MC 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-857-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04133363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant