Provider Demographics
NPI:1154368744
Name:BLESSING, JENNIFER L (PA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:BLESSING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4402
Mailing Address - Country:US
Mailing Address - Phone:210-358-4000
Mailing Address - Fax:210-615-1905
Practice Address - Street 1:4502 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4402
Practice Address - Country:US
Practice Address - Phone:210-358-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10663363A00000X
FLPA9102502363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4130734OtherAETNA HMO
FL592207264OtherCIGNA PPO
FL36291OtherBCBS
FL0599681OtherGHI PPO
FL1716925002OtherCIGNA HMO
FL592207264EOtherHUMANA
FL4130734OtherAETNA HMO
FL592207264EOtherHUMANA
FL1716925002OtherCIGNA HMO
FL36291OtherBCBS
FL0664623OtherAETNA PPO
FLU1913ZMedicare PIN
FL592207264OtherCIGNA PPO
FLQ06327Medicare UPIN