Provider Demographics
NPI:1356061121
Name:STEARNS, JENNETTA SUE (FNP)
Entity type:Individual
Prefix:MRS
First Name:JENNETTA
Middle Name:SUE
Last Name:STEARNS
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 1:9229 COUNTY ROAD 607
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-8219
Mailing Address - Country:US
Mailing Address - Phone:573-624-1030
Mailing Address - Fax:
Practice Address - Street 1:806 N DOUGLASS ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1512
Practice Address - Country:US
Practice Address - Phone:573-276-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022034951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily