Provider Demographics
NPI:1245451475
Name:MCDERMOTT, JANA SUE (RN, ANP)
Entity type:Individual
Prefix:MRS
First Name:JANA
Middle Name:SUE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
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Mailing Address - Street 1:823 JUNCTION HWY
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028
Mailing Address - Country:US
Mailing Address - Phone:830-258-7900
Mailing Address - Fax:830-258-7820
Practice Address - Street 1:823 JUNCTION HWY
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5056
Practice Address - Country:US
Practice Address - Phone:830-258-7900
Practice Address - Fax:830-258-7820
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249021363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health