Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Nicole Blackwell Jennings, PA-C

Individual provider Medical Physician Assistant · NPI 1730290990

Mrs. Nicole Blackwell Jennings, PA-C is a Medical Physician Assistant in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2006.

Licensed in
TX
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1500 Cooper St
Fort Worth, TX 76104-2710
Phone: (682) 885-2500
Fax: (682) 885-2510
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA04862 (TX)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA04862 (TX)

Record details

NPI number1730290990
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESMay 18, 2021
Certification dateMay 18, 2021

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