Doctor Name: | JANA TRISTAN |
NPI Number: | 1467823831 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | AP129171 |
Business Practice Address: | One Medical Plaza Pampa, TX - 79065 |
Business Phone Number: | 8066888800 |
Business Fax Number: | 8066881176 |
Mailing Address: | One Medical Plaza, PAMPA |
State: | TX |
Postal Code: | 79065 |
Phone Number: | 8066888800 |
Fax Number: | 8066881176 |
NPI Enumeration Date: | 10/12/2015 |
NPI Last Update Date: | 10/12/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | AP129171 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |