Provider Demographics
NPI:1649941204
Name:STEWART, JANA NICHOLE (FNP)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:NICHOLE
Last Name:STEWART
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 1:1406 N AVENUE J
Mailing Address - Street 2:
Mailing Address - City:HASKELL
Mailing Address - State:TX
Mailing Address - Zip Code:79521-3336
Mailing Address - Country:US
Mailing Address - Phone:940-207-0068
Mailing Address - Fax:
Practice Address - Street 1:1850 HICKORY ST STE 103
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2334
Practice Address - Country:US
Practice Address - Phone:325-268-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily