Provider Demographics
NPI:1881358265
Name:JUAREZ, FEHREN BRANDI (FNP)
Entity type:Individual
Prefix:
First Name:FEHREN
Middle Name:BRANDI
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 BENNER
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2230
Mailing Address - Country:US
Mailing Address - Phone:512-298-1645
Mailing Address - Fax:512-298-1795
Practice Address - Street 1:4210 BENNER
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2230
Practice Address - Country:US
Practice Address - Phone:512-298-1645
Practice Address - Fax:512-298-1795
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057354363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily