Provider Demographics
NPI:1528302130
Name:NEGARD, JEFFRY THOMAS (RN, DNP-FNP)
Entity type:Individual
Prefix:DR
First Name:JEFFRY
Middle Name:THOMAS
Last Name:NEGARD
Suffix:
Gender:M
Credentials:RN, DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BROOKER ARMY MEDICAL CTR
Mailing Address - Street 2:3551 ROGER BROOKE DRIVE,
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-539-9582
Mailing Address - Fax:
Practice Address - Street 1:BROOKE ARMY MEDICAL CENTER
Practice Address - Street 2:3551 ROGER BROOKE DR
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-539-9582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA705686OtherRN LICENSE
WARN60610220OtherRN LICENSE
TX966505OtherRN LICENSE
WAAP60676999OtherAPRN - NP LICENSE