Individual
JANA TRISTAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1901 MEDI PARK DR STE 2002, AMARILLO, TX 79106-2108
(806) 353-4699
(806) 353-4551
Mailing address
1901 MEDI PARK DR STE 2036, AMARILLO, TX 79106-2109
(806) 468-4625
(806) 468-4626
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP129171
TX
363LF0000X
Family Nurse Practitioner
AP129171
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358670306
—
TX
Enumeration date
10/12/2015
Last updated
06/09/2020
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