Provider Demographics
NPI:1528529815
Name:STANCIL, KARISA RAE (FNP-C)
Entity type:Individual
Prefix:
First Name:KARISA
Middle Name:RAE
Last Name:STANCIL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15808 RANCH ROAD 620 N STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4923
Mailing Address - Country:US
Mailing Address - Phone:512-244-3554
Mailing Address - Fax:512-244-2942
Practice Address - Street 1:505 W LOUIS HENNA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-1702
Practice Address - Country:US
Practice Address - Phone:855-481-8375
Practice Address - Fax:512-244-2942
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily