Provider Demographics
NPI:1205258068
Name:STUART, KATRINA JEANETTE (APRN, NNP-BC)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:JEANETTE
Last Name:STUART
Suffix:
Gender:F
Credentials:APRN, NNP-BC
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Other - Credentials:
Mailing Address - Street 1:1121 E SPRING CREEK PKWY.
Mailing Address - Street 2:STE. 110, #319
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:214-343-6663
Mailing Address - Fax:214-343-2814
Practice Address - Street 1:12505 LEBANON RD
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8298
Practice Address - Country:US
Practice Address - Phone:214-343-6663
Practice Address - Fax:214-343-2814
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX749624163W00000X
TXAP125611363LN0000X
TX125611363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal