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General NPI Number Information
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NPI Number | 1316553043
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Entity Type | Organization
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Legal Business Name | ADJUVA PRIMARY CARE INC.
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 4901 STATE HIGHWAY 114 SUITE 102
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City | NORTHLAKE
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State | TX
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Zip | 76262-1466
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Country | US
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Telephone | 817-554-2121
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Fax | 817-813-8183
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Provider Business Mailing Address
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Address Line | 4901 STATE HIGHWAY 114 SUITE 102
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City | NORTHLAKE
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State | TX
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Zip | 76262-1466
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Country | US
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Telephone | 817-554-2121
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Fax | 817-813-8183
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MARGARET ADEE STINNETT
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Credential | DNP, APRN, FNP-BC
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Telephone | 817-554-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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