Jennifer Mingboupha, LVN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

351888 Issued in TX

Practice address

509 Molly LN
Lindale, TX 75771-6537

Phone

(682) 219-8677

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1043829336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MOLLY LN",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757716537",
            "telephone_number": "682-219-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MOLLY LN",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757716537",
            "telephone_number": "682-219-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINGBOUPHA",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "351888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Russell McDaniel, MD
• Mary McLean
• Elizabeth A McLeod, DO
• Merritt Mobile Therapy, PLLC
• Karen Ann Miller, SLP
• Yolanda Shannell Morris
• Mother Frances Hospital
• Mother Frances Hospital
• John Motley
• Melissa Munoz

• Licensed Practical Nurse in Lindale, TX
• Providers in Lindale, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.