Provider Demographics
NPI:1659260818
Name:FENNELL, KARI AMANDA (FNP-C)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:AMANDA
Last Name:FENNELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:AMANDA
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:11007 QUAKER AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-8317
Mailing Address - Country:US
Mailing Address - Phone:806-701-4040
Mailing Address - Fax:
Practice Address - Street 1:11007 QUAKER AVE STE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-8317
Practice Address - Country:US
Practice Address - Phone:806-701-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1205675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily