Provider Demographics
NPI:1982399606
Name:TUDOR, JENNIFER M (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:TUDOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:BRUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3316 N NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7129
Mailing Address - Country:US
Mailing Address - Phone:480-734-5431
Mailing Address - Fax:
Practice Address - Street 1:1510 E FLOWER ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5656
Practice Address - Country:US
Practice Address - Phone:602-954-0444
Practice Address - Fax:602-952-7146
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ284546363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily