Provider Demographics
NPI:1023859535
Name:HA, JENNIFER RENEE (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:HA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 ROCKY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4750
Mailing Address - Country:US
Mailing Address - Phone:907-350-4419
Mailing Address - Fax:
Practice Address - Street 1:3281 ROCKY CREEK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4750
Practice Address - Country:US
Practice Address - Phone:281-916-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1166004363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily