Provider Demographics
NPI:1497110894
Name:JEANES, ERIN R (FNP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:JEANES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 N MAIN ST
Mailing Address - Street 2:SUITE1
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1110
Mailing Address - Country:US
Mailing Address - Phone:254-939-1844
Mailing Address - Fax:254-939-1619
Practice Address - Street 1:2851 N MAIN ST
Practice Address - Street 2:SUITE1
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1110
Practice Address - Country:US
Practice Address - Phone:254-939-1844
Practice Address - Fax:254-939-1619
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily