Provider Demographics
NPI:1245627140
Name:DARNUTZER, JESSICA LONG (APRN, FNP-C)
Entity type:Individual
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First Name:JESSICA
Middle Name:LONG
Last Name:DARNUTZER
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Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:6210 E HIGHWAY 290 STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9569
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:6818 AUSTIN CENTER BLVD STE 205
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3100
Practice Address - Country:US
Practice Address - Phone:512-344-0450
Practice Address - Fax:512-406-7318
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2020-12-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP128401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX380744802Medicaid
TX380744803Medicaid