MRS. JACQUELYN PHYLLIS REYNA-STOVALL RN DNP CNE FNP-BC NPI 1063787026

NPI Information

NPI: 1063787026
Provider Name: MRS. JACQUELYN PHYLLIS REYNA-STOVALL, RN, DNP, CNE, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
3320 OAKWELL CT
SAN ANTONIO, TX
ZIP 78218
Phone: (210) 829-5180
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MRS. Jacquelyn Phyllis Reyna-stovall, RN, DNP, CNE, FNP-BC is a family nurse practitioner in San Antonio, TX. MRS. Jacquelyn Phyllis Reyna-stovall, RN, DNP, CNE, FNP-BC NPI is 1063787026. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3320 OAKWELL CT
SAN ANTONIO, TX
ZIP 78218-019
Phone: (210) 829-5180

The enumeration date for this NPI number is 3/9/2012 and was last updated on 1/14/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	672302	TEXAS	No
2	363LF0000X	Nurse Practitioner	Family	AP121531	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12363634	OTHER		CAQH
2	3043374-01	MEDICAID	TEXAS
3	3043374-02	MEDICAID	TEXAS
4	AP121531	OTHER	TEXAS	TEXAS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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