JACOB RYAN STILLWAGON


Address: 1501 S Coulter St, Amarillo, TX 79106-1770
Phone: 8063541000

JACOB RYAN STILLWAGON (NPI# 1083071468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083071468
Entity Type Individual
Full Name JACOB RYAN STILLWAGON
Credential RN, NP-C
Practice Address 1501 S Coulter St
Amarillo
TX 79106-1770
Mailing Address 7004 Voyager Trl
Amarillo
TX 79118-9122
Practice Telephone 8063541000
Mailing Telephone 8068980520
Enumeration Date 2016-01-15
Last Update Date 2016-05-27
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 803586 TX Nursing Service Providers
Y 363LF0000X Nurse Practitioner
Specialization: Family
AP130118 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1501 S COULTER ST
City AMARILLO
State TX
Zip Code 79106-1770

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467442418 Northwest Texas Healthcare System Inc Clinic/Center 1501 S Coulter St, Amarillo, TX 79106-1770 2005-10-21
1104431576 Gregory Allan Fenchel Jr. Nurse Anesthetist, Certified Registered 1501 S Coulter St, Amarillo, TX 79106-1770 2020-09-12
1457962888 Mercedes Ontiveros Respiratory Therapist, Certified 1501 S Coulter St, Amarillo, TX 79106-1770 2020-08-10
1780209627 Connie Lea Clement Counselor 1501 S Coulter St, Amarillo, TX 79106-1770 2020-06-16
1215552336 Simon Salazar Camarillo IIi Counselor 1501 S Coulter St, Amarillo, TX 79106-1770 2020-06-15
1063049245 Joshua Michael Pritchet Nurse Anesthetist, Certified Registered 1501 S Coulter St, Amarillo, TX 79106-1770 2020-03-26
1093367419 Emily Marie Buatois Pharmacist 1501 S Coulter St, Amarillo, TX 79106-1770 2019-07-15
1336622042 Katharine Ruth Diaz Physical Medicine & Rehabilitation 1501 S Coulter St, Amarillo, TX 79106-1770 2018-09-09
1619454394 Shayne R Teichelman Nurse Practitioner 1501 S Coulter St, Amarillo, TX 79106-1770 2018-07-25
1114435922 Matthew Alan Manley Nurse Anesthetist, Certified Registered 1501 S Coulter St, Amarillo, TX 79106-1770 2018-01-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538773205 Nisha Patel Pharmacist 1600 S Western Street, Amarillo, TX 79106 2020-09-01
1043851769 Diana Moore Pharmacist 6010 Amarillo Blvd W (119), Amarillo, TX 79106 2019-10-03
1164988127 Wade Family Services Pllc Counselor 1901 Medi Park Dr Suite 130, Amarillo, TX 79106 2019-02-14
1255802963 Jennifer Cockrum Hospitalist Bsa Hospitalist, 1600 Wallace Blvd., Amarillo, TX 79106 2018-12-07
1346736691 Denise Mills Donnell Social Worker 6010 Amarillo Bouldevard West Clc-b, Amarillo, TX 79106 2018-07-10
1124525472 Abigail Batson Student in an Organized Health Care Education/Training Program 1400 S Coulter Street, Suite 1500, Amarillo, TX 79106 2018-04-11
1053812743 Moc Amarillo, LLC Skilled Nursing Facility 1540 Research St., Amarillo, TX 79106 2018-02-27
1013459437 Larry G. Schulz Durable Medical Equipment & Medical Supplies 1901 Medi Park Dr Ste 219, Amarillo, TX 79106 2016-11-16
1922453315 Omar Saeed M Alzhrani Student in an Organized Health Care Education/Training Program 1400 S. Coulter - Suite 5100, Amarillo, TX 79106 2016-05-04
1972967529 David Wayne Hohon Internal Medicine Bsa Physician Group, 1600 Wallace Blvd., Amarillo, TX 79106 2016-04-11
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083229629 Donna Jeannette Mccauley Nurse Practitioner 7407 Imperial Dr, Amarillo, TX 79121-1429 2020-09-10
1902414998 Sarah Jane Fisk Nurse Practitioner 1901 Medi Park Dr Ste 103, Amarillo, TX 79106-2106 2020-07-16
1801410063 Jeannette Sandoval Nurse Practitioner 2329 Ross Osage, Amarillo, TX 79103-3000 2020-06-03
1962044941 Donna Raef Kizziar Nurse Practitioner Bsa Urgent Care Clinic, 4510 Bell St., Amarillo, TX 79109 2019-10-11
1225679400 Wendy Dawn Guest Nurse Practitioner 7716 Pinnacle Dr, Amarillo, TX 79119-7494 2019-09-30
1326609835 Chelsea Beth Stevens Nurse Practitioner 609 S Carolina St, Amarillo, TX 79106-8721 2019-06-25
1184187759 Lauren Altendorf Nurse Practitioner 3501 S Soncy Rd Ste 110, Amarillo, TX 79119-6405 2019-04-10
1851853311 Sandra Renee Morris Boyd Nurse Practitioner 20001 Wind River Dr, Amarillo, TX 79124-1682 2019-04-03
1245795780 Monica Favela Prieto Nurse Practitioner Bsa Urgent Care Clinc, 4510 Bell St., Amarillo, TX 79109 2019-02-08
1609349042 Sarah Price Nurse Practitioner 5109 Navajo Trl, Amarillo, TX 79110-4635 2019-01-08
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Competitor

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City AMARILLO
Zip Code 79106

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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