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General NPI Number Information
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NPI Number | 1649941204
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Entity Type | Individual
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Provider Name | JANA NICHOLE STEWART FNP
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Gender | Female
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 04/24/2022
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Provider Practice Location Address
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Address Line | 1850 HICKORY ST STE 103
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City | ABILENE
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State | TX
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Zip | 79601-2334
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Country | US
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Telephone | 325-268-4122
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 N AVENUE J
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City | HASKELL
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State | TX
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Zip | 79521-3336
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Country | US
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Telephone | 940-207-0068
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1071222
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License Number State | TX
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