Provider Demographics
NPI:1003363870
Name:HRUZ, JENNIFER HIDALGO
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:HIDALGO
Last Name:HRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:ELAINE
Other - Last Name:HIDALGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:12625 W BURLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3157
Mailing Address - Country:US
Mailing Address - Phone:262-777-8482
Mailing Address - Fax:262-333-2142
Practice Address - Street 1:12625 W BURLEIGH RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3157
Practice Address - Country:US
Practice Address - Phone:262-777-8482
Practice Address - Fax:262-333-2142
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2016013734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily