Provider Demographics
NPI:1730618711
Name:MACKEY, JENNIFER P
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:P
Last Name:MACKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 RAYFORD RD APT 324
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3562
Mailing Address - Country:US
Mailing Address - Phone:281-435-4234
Mailing Address - Fax:
Practice Address - Street 1:425 RAYFORD RD APT 324
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-3562
Practice Address - Country:US
Practice Address - Phone:281-435-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker