Provider Demographics
NPI:1851341648
Name:YARROW, JENNIFER JEAN (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:YARROW
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6623 S ZARZAMORA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-3245
Mailing Address - Country:US
Mailing Address - Phone:210-761-3393
Mailing Address - Fax:210-761-3397
Practice Address - Street 1:6623 S ZARZAMORA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3245
Practice Address - Country:US
Practice Address - Phone:210-761-3393
Practice Address - Fax:210-761-3397
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1530363AM0700X
TXPA03577363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1Y3538OtherMEDICARE