Provider Demographics
NPI:1104445386
Name:STONE, STEPHENY T (APRN, NNP-BC)
Entity type:Individual
Prefix:
First Name:STEPHENY
Middle Name:T
Last Name:STONE
Suffix:
Gender:F
Credentials:APRN, NNP-BC
Other - Prefix:
Other - First Name:STEPHENY
Other - Middle Name:N
Other - Last Name:THACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6233 BUSH BUCK RUN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3655
Mailing Address - Country:US
Mailing Address - Phone:817-507-5578
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145768363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal