Basic Information
| Provider Information | |||||||||
| NPI: | 1912331745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOTO | ||||||||
| FirstName: | JANA | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | REESE | ||||||||
| OtherFirstName: | JANA | ||||||||
| OtherMiddleName: | RAE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1000 FM 300 | ||||||||
| Address2: | |||||||||
| City: | LEVELLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 793366235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068947842 | ||||||||
| FaxNumber: | 8068943378 | ||||||||
| Practice Location | |||||||||
| Address1: | 1318 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794013206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067652611 | ||||||||
| FaxNumber: | 8067413015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2013 | ||||||||
| LastUpdateDate: | 02/13/2017 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 764630 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.