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General NPI Number Information
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NPI Number | 1730437260
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Entity Type | Individual
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Provider Name | JAMIE RENEE STICE NP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 6405 107TH ST STE 200
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City | LUBBOCK
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State | TX
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Zip | 79424-8210
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Country | US
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Telephone | 806-878-0254
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Fax | 806-553-6291
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Provider Business Mailing Address
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Address Line | 1917 30TH ST
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City | LUBBOCK
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State | TX
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Zip | 79411-1803
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Country | US
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Telephone | 806-786-6258
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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 | 694160TX
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License Number State | TX
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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 | AP122254
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License Number State | TX
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