Jennifer Renee Wren, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9103522 Issued in FL

Practice address

1820 Barrs St
Suite 701
Jacksonville, FL 32204-4742

Phone

(904) 421-5586

Fax

(904) 389-6748

NPI assigned

Nov 22, 2005

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)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407839616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 BARRS ST",
            "address_2": "SUITE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044742",
            "telephone_number": "904-421-5586",
            "fax_number": "904-389-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 BARRS ST",
            "address_2": "SUITE 701",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044742",
            "telephone_number": "904-421-5586",
            "fax_number": "904-389-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mia Wray
• Michael Maurice Wray, DMD
• Wright Medical , LLC
• Rechelle Oline Wright-Glidewell
• Tara Louchun Wright-Mitchell, LMHC
• Alexandria Wright, OTA
• Alonzo C Wright, MSW

• Surgical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.