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Individual

MS. JENNIFER DONNELLY CUSHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7201 76TH ST, LUBBOCK, TX 79424-0722
(806) 239-3017
Mailing address
7201 76TH ST, LUBBOCK, TX 79424-0722
(806) 239-3017

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
PA2017-0003
NM
363A00000X
Physician Assistant
PA11037
TX
363A00000X
Physician Assistant
PA61021112
WA
363A00000X
Physician Assistant
Primary
PAC0756
ND
363AM0700X
Medical Physician Assistant
PA2017-0003
NM
363AM0700X
Medical Physician Assistant
PA61021112
WA
363AM0700X
Medical Physician Assistant

Other

Enumeration date
08/02/2016
Last updated
03/18/2026
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