Provider Demographics
NPI:1932254026
Name:TITUS, JENNY A (DNP, FPMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:A
Last Name:TITUS
Suffix:
Gender:F
Credentials:DNP, FPMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1163
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-1163
Mailing Address - Country:US
Mailing Address - Phone:888-504-4074
Mailing Address - Fax:307-462-0662
Practice Address - Street 1:733 BIG HORN AVE STE 1
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-2605
Practice Address - Country:US
Practice Address - Phone:888-504-4074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY19926.0821363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health