Provider Demographics
NPI:1235958091
Name:ADAMS, JENNA (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:
Last Name:ADAMS
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 1:561 S HIGHLAND DR APT 3
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-1055
Mailing Address - Country:US
Mailing Address - Phone:614-330-2722
Mailing Address - Fax:
Practice Address - Street 1:561 S HIGHLAND DR APT 3
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1055
Practice Address - Country:US
Practice Address - Phone:614-330-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily