Provider Demographics
NPI:1316553043
Name:ADJUVA PRIMARY CARE INC.
Entity Type:Organization
Organization Name:ADJUVA PRIMARY CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ADEE
Authorized Official - Last Name:STINNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-BC
Authorized Official - Phone:817-554-2121
Mailing Address - Street 1:4901 STATE HIGHWAY 114
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-1466
Mailing Address - Country:US
Mailing Address - Phone:817-554-2121
Mailing Address - Fax:817-813-8183
Practice Address - Street 1:4901 STATE HIGHWAY 114
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76262-1466
Practice Address - Country:US
Practice Address - Phone:817-554-2121
Practice Address - Fax:817-813-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care