Provider Demographics
NPI:1871251926
Name:STARNER, JAYANDRA (NP-C)
Entity Type:Individual
Prefix:
First Name:JAYANDRA
Middle Name:
Last Name:STARNER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1595 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3329
Mailing Address - Country:US
Mailing Address - Phone:830-816-5024
Mailing Address - Fax:830-331-9058
Practice Address - Street 1:1595 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3329
Practice Address - Country:US
Practice Address - Phone:830-816-5024
Practice Address - Fax:830-331-9058
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1059023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily