Individual
MS. JENNIFER LYNN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
3920 W WHEATLAND RD, SUITE 134, DALLAS, TX 75237-3401
(214) 941-3192
(877) 959-4622
Mailing address
3920 W WHEATLAND RD, SUITE 134, DALLAS, TX 75237-3401
(214) 941-3192
(877) 959-4622
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
119713-030
WI
363L00000X
Nurse Practitioner
Primary
846819
TX
363LF0000X
Family Nurse Practitioner
209010913
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39990700
—
WI
Enumeration date
05/14/2006
Last updated
03/28/2024
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