Provider Demographics
NPI:1841564762
Name:EARNHARDT, JENNINE MORGAN (DC)
Entity type:Individual
Prefix:
First Name:JENNINE
Middle Name:MORGAN
Last Name:EARNHARDT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JENNINE
Other - Middle Name:CAROL
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7904 CHAPELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-6724
Mailing Address - Country:US
Mailing Address - Phone:603-591-8723
Mailing Address - Fax:
Practice Address - Street 1:1205 S WHITE CHAPEL BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9341
Practice Address - Country:US
Practice Address - Phone:603-591-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012092111N00000X
TX15736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor