Provider Demographics
NPI:1144690512
Name:STUART, JENNIFER L (APRN)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:STUART
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1131
Mailing Address - Country:US
Mailing Address - Phone:620-669-2648
Mailing Address - Fax:620-694-2128
Practice Address - Street 1:322 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460-4316
Practice Address - Country:US
Practice Address - Phone:620-504-6187
Practice Address - Fax:316-866-2084
Is Sole Proprietor?:No
Enumeration Date:2015-09-29
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS76954363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner