Provider Demographics
NPI:1871690172
Name:STONNER, JANE B (APRN)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:B
Last Name:STONNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11863 STATE HIGHWAY 13
Mailing Address - Street 2:PO BOX 555
Mailing Address - City:KIMBERLING CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65686-8362
Mailing Address - Country:US
Mailing Address - Phone:417-739-1995
Mailing Address - Fax:417-739-1893
Practice Address - Street 1:11016 E STATE HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-9775
Practice Address - Country:US
Practice Address - Phone:417-272-0400
Practice Address - Fax:417-272-0428
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO058560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00125467OtherRAILROAD MEDICARE
27276OtherBCBS