Provider Demographics
NPI:1992412704
Name:FLETCHER, JODI LEIGH (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MISS
First Name:JODI
Middle Name:LEIGH
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MSN, 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 1:575 18TH STREET STE 4
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-9008
Mailing Address - Country:US
Mailing Address - Phone:409-291-0118
Mailing Address - Fax:409-225-5023
Practice Address - Street 1:575 18TH STREET STE 4
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77632-9008
Practice Address - Country:US
Practice Address - Phone:409-291-0118
Practice Address - Fax:409-225-5023
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097098363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care