Provider Demographics
NPI:1528341559
Name:STALDER, JANEL (FNP)
Entity type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:STALDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:
Other - Last Name:STALDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2720 W. VIRGINIA PKWY, #500
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071
Mailing Address - Country:US
Mailing Address - Phone:972-542-1205
Mailing Address - Fax:866-433-1632
Practice Address - Street 1:2720 W. VIRGINIA PKWY, #500
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7040
Practice Address - Country:US
Practice Address - Phone:972-542-1205
Practice Address - Fax:866-433-1632
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily