Provider Demographics
NPI:1407541592
Name:STONE, JEANNA RENEE (APRN FNP-BC)
Entity Type:Individual
Prefix:
First Name:JEANNA
Middle Name:RENEE
Last Name:STONE
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5124 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-6032
Mailing Address - Country:US
Mailing Address - Phone:817-690-8575
Mailing Address - Fax:
Practice Address - Street 1:914 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2503
Practice Address - Country:US
Practice Address - Phone:940-464-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094000208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice