Provider Demographics
NPI:1306428537
Name:TARR, JENNIFER MORGAN (RN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MORGAN
Last Name:TARR
Suffix:
Gender:F
Credentials:RN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 TULLIE DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-6059
Mailing Address - Country:US
Mailing Address - Phone:903-241-5303
Mailing Address - Fax:
Practice Address - Street 1:705 E MARSHALL AVE STE 1002
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5660
Practice Address - Country:US
Practice Address - Phone:903-759-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX852035163W00000X
TX1029543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse