Individual provider · Type 1 NPI
Jackie Ijeoma Penn, NP
Psychiatric/Mental Health Nurse Practitioner · Grand Prairie, TX
NPI number
1972940260
Active
Practice location
5319 Nueces Ln
Grand Prairie, TX 75052-2667
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 783349 (TX) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 1056737 (TX) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1972940260
Jackie Ijeoma Penn, NP's National Provider Identifier is 1972940260, issued on May 28, 2013. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Grand Prairie, TX. The record was last updated on May 3, 2024.