Individual
MRS. JACKIE K WURTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11515 FM 1960 RD STE C, HUFFMAN, TX 77336-4431
(281) 324-1550
(281) 324-1555
Mailing address
PO BOX 1365, HUFFMAN, TX 77336-1365
(281) 324-1550
(281) 324-1555
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
564809
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171697903
—
TX
Enumeration date
05/09/2007
Last updated
09/20/2011
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