Provider Demographics
NPI:1740929652
Name:SHURETTE, JENNIFER RENEE (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:SHURETTE
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 TIMBER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:WEOGUFKA
Mailing Address - State:AL
Mailing Address - Zip Code:35183-2265
Mailing Address - Country:US
Mailing Address - Phone:256-404-9045
Mailing Address - Fax:
Practice Address - Street 1:314 E STATE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4318
Practice Address - Country:US
Practice Address - Phone:256-404-9045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-095455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily