Provider Demographics
NPI:1154727790
Name:STOCKHORST, DANIELLE (FNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:STOCKHORST
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 HIGHWAY 97 E STE 280
Mailing Address - Street 2:
Mailing Address - City:JOURDANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78026-1539
Mailing Address - Country:US
Mailing Address - Phone:830-769-5912
Mailing Address - Fax:830-769-5913
Practice Address - Street 1:1907 HIGHWAY 97 E STE 280
Practice Address - Street 2:
Practice Address - City:JOURDANTON
Practice Address - State:TX
Practice Address - Zip Code:78026-1539
Practice Address - Country:US
Practice Address - Phone:830-769-5912
Practice Address - Fax:830-769-5913
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX380505YLLWOtherMEDICARE