1548699267 NPI number — JENNIFER COREY FIANDT FNP-C, RN

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548699267 NPI number — JENNIFER COREY FIANDT FNP-C, RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIANDT
Provider First Name:
JENNIFER
Provider Middle Name:
COREY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C, RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COREY
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548699267
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5610 80TH AVENUE CT W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSITY PLACE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98467-3939
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-425-7741
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9040A JACKSON AVE MADIGAN ARMY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOINT BASE LEWIS MCCHORD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-4613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-1110
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  170579-030 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 33-7932 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)