Individual
JENNIFER PEHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
749608
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP124959
TX
390200000X
Student in an Organized Health Care Education/Training Program
749608
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329947102
—
TX
01
—
8811UG
BCBS
TX
01
—
P01357123
RR
TX
Enumeration date
12/19/2013
Last updated
06/11/2018
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