Provider Demographics
NPI:1346612769
Name:JOHN, FENI STANLEY (RN-FNP, AGACNP)
Entity type:Individual
Prefix:MRS
First Name:FENI
Middle Name:STANLEY
Last Name:JOHN
Suffix:
Gender:
Credentials:RN-FNP, AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 FENWICK DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-3222
Mailing Address - Country:US
Mailing Address - Phone:972-203-8096
Mailing Address - Fax:972-203-8096
Practice Address - Street 1:5308 N GALLOWAY AVE STE 201
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-1125
Practice Address - Country:US
Practice Address - Phone:469-800-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-25
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129044363LF0000X
TX2021161511363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily