Provider Demographics
NPI:1336258276
Name:CAPOZZI, JENNIFER E (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:CAPOZZI
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 1:9150 HUEBNER RD STE 290
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1598
Mailing Address - Country:US
Mailing Address - Phone:210-614-6432
Mailing Address - Fax:210-293-2989
Practice Address - Street 1:9150 HUEBNER RD STE 290
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1598
Practice Address - Country:US
Practice Address - Phone:210-614-6432
Practice Address - Fax:210-293-2989
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1047283363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A728342Medicare ID - Type Unspecified