Provider Demographics
NPI:1356495683
Name:SOWARD, JANA TOMARA (CPNP)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:TOMARA
Last Name:SOWARD
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4748
Mailing Address - Country:US
Mailing Address - Phone:919-934-0564
Mailing Address - Fax:919-934-9703
Practice Address - Street 1:11 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577
Practice Address - Country:US
Practice Address - Phone:919-934-0564
Practice Address - Fax:919-934-9703
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300242363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7005951Medicaid