Provider Demographics
NPI:1992338198
Name:URIOSTEGUI, JENNIFER CAROLYN (LVN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CAROLYN
Last Name:URIOSTEGUI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5117
Mailing Address - Country:US
Mailing Address - Phone:214-514-9225
Mailing Address - Fax:
Practice Address - Street 1:4099 MCEWEN RD
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-5030
Practice Address - Country:US
Practice Address - Phone:214-514-9225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-16
Last Update Date:2020-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21344164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse