Individual
MRS. JENNIFER LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-C
Contact information
Practice address
208 W BEN WHITE BLVD, AUSTIN, TX 78704
(512) 861-8060
Mailing address
208 W BEN WHITE BLVD, AUSTIN, TX 78704-7126
(512) 861-8060
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP138746
TX
Other
Enumeration date
10/01/2018
Last updated
10/19/2018
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