Provider Demographics
NPI:1902317969
Name:ALBIN, JENNIFER LEANNE (FNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEANNE
Last Name:ALBIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 649113
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75264-9113
Mailing Address - Country:US
Mailing Address - Phone:601-339-2065
Mailing Address - Fax:888-353-5763
Practice Address - Street 1:120 STONE CREEK BLVD STE 500
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8210
Practice Address - Country:US
Practice Address - Phone:601-420-2040
Practice Address - Fax:601-420-2356
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily