Provider Demographics
NPI:1669128500
Name:ANTU, JELSA (APRN-FNPC)
Entity type:Individual
Prefix:MRS
First Name:JELSA
Middle Name:
Last Name:ANTU
Suffix:
Gender:F
Credentials:APRN-FNPC
Other - Prefix:
Other - First Name:JELSA
Other - Middle Name:
Other - Last Name:MENACHERY ANTU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7323 RAVENSWOOD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:832-704-8317
Mailing Address - Fax:
Practice Address - Street 1:RIGHT STEP MEDICAL CENTER
Practice Address - Street 2:11925 SOUTHWEST FWY SUITE #12
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477
Practice Address - Country:US
Practice Address - Phone:281-741-9145
Practice Address - Fax:713-461-3518
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072593363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily