Provider Demographics
NPI:1376729921
Name:MCINTYRE, JENNIFER GREGG (APRN-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GREGG
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 E HILL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4336
Mailing Address - Country:US
Mailing Address - Phone:678-833-6899
Mailing Address - Fax:770-460-4045
Practice Address - Street 1:5033 W HIGHWAY 290
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6751
Practice Address - Country:US
Practice Address - Phone:512-265-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN211545363L00000X
KS53-83417-121363LF0000X
MO2024030697363LF0000X
FL11033589363LF0000X
TN36769363LF0000X
SC29533363LF0000X
VA0024192009363LF0000X
MSR857047363LF0000X
NV879772363LF0000X
UT14074980-4405363LF0000X
CO0102559363LF0000X
TX1070407363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner