Provider Demographics
NPI:1922890201
Name:GENN, JOANNE RENEE (FNP-C)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:RENEE
Last Name:GENN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 CONDO RD
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2316
Mailing Address - Country:US
Mailing Address - Phone:806-679-8975
Mailing Address - Fax:
Practice Address - Street 1:3023 PERRYTON PKWY STE 101
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2817
Practice Address - Country:US
Practice Address - Phone:806-665-0801
Practice Address - Fax:806-665-8503
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1204982OtherLICENSE