Provider Demographics
NPI:1740056407
Name:IBEKWE, JENNIFER I (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:I
Last Name:IBEKWE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 E MOCKINGBIRD LN # 2979
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2601
Mailing Address - Country:US
Mailing Address - Phone:469-956-9226
Mailing Address - Fax:
Practice Address - Street 1:3024 HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4037
Practice Address - Country:US
Practice Address - Phone:817-494-5000
Practice Address - Fax:817-494-5001
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1137334363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily