Provider Demographics
NPI:1780915777
Name:BAXTER, JANA E (RN, MSN, CFNP)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:E
Last Name:BAXTER
Suffix:
Gender:F
Credentials:RN, MSN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4529
Mailing Address - Country:US
Mailing Address - Phone:972-298-6174
Mailing Address - Fax:972-709-1570
Practice Address - Street 1:222 S CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4529
Practice Address - Country:US
Practice Address - Phone:972-298-6174
Practice Address - Fax:972-709-1570
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX666524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily