MEDICARE: MRS. JESSICA JANE STONE GNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	A01537	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366508756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA JANE STONE GNP-BC

Provider Business Mailing Address
First Line	:	261 E COLUMBIA # 77
Second Line	:
City	:	MAGNOLIA
State	:	AR
Zip	:	71753
Country	:	US
Telephone Number	:	870-299-3893
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 WARNOCK SPRINGS RD
Second Line	:
City	:	MAGNOLIA
State	:	AR
Zip	:	71753-9000
Country	:	US
Telephone Number	:	337-991-9276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	05/11/2026

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