Provider Demographics
NPI:1215437207
Name:BATTLES, JENNA DORSEY (LVN)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:DORSEY
Last Name:BATTLES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:JENNA
Other - Middle Name:DIANE
Other - Last Name:BATTLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:404 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BURKBURNETT
Mailing Address - State:TX
Mailing Address - Zip Code:76354-3522
Mailing Address - Country:US
Mailing Address - Phone:940-280-3830
Mailing Address - Fax:
Practice Address - Street 1:908 8TH ST STE 100
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-6815
Practice Address - Country:US
Practice Address - Phone:940-761-9986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232330164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse