| Doctor Name: | JENNIFER RUBIO GREDICEK |
| NPI Number: | 1073946984 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 642100 |
| Business Practice Address: | 209 S Church St Suite B Lockhart, TX - 786442713 |
| Business Phone Number: | 5123762999 |
| Business Fax Number: | 5123765562 |
| Mailing Address: | 209 S Church St, Suite B LOCKHART |
| State: | TX |
| Postal Code: | 786442713 |
| Phone Number: | 5123762999 |
| Fax Number: | 5123765562 |
| NPI Enumeration Date: | 08/14/2013 |
| NPI Last Update Date: | 10/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 642100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |