Doctor Name: | MRS. JANA RENE FUNKHOUSER |
NPI Number: | 1760409684 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | J2123 |
Business Practice Address: | 200 County Road 340a Ste 2 Burnet, TX - 786114537 |
Business Phone Number: | 5127153110 |
Business Fax Number: | 5127150678 |
Mailing Address: | Po Box 1219, BURNET |
State: | TX |
Postal Code: | 786117219 |
Phone Number: | 5127153364 |
Fax Number: | 5124066505 |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 06/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | J2123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |