Provider Demographics
NPI:1952741084
Name:KUCERA, JENNIFER L (FNP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:KUCERA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-4733
Mailing Address - Country:US
Mailing Address - Phone:979-245-2421
Mailing Address - Fax:979-245-6263
Practice Address - Street 1:208 N MCKINNEY ST # 2
Practice Address - Street 2:
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480-3404
Practice Address - Country:US
Practice Address - Phone:979-245-2421
Practice Address - Fax:979-245-6263
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123697363L00000X
TX597568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner