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Individual
MARY P STANLEY
Active
Individual
MARY P STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
520511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159612758
—
AR
05
—
185323601
—
TX
01
—
8Y0116
BLUE CROSS
TX
01
—
A01684
LICENSE
AR
Enumeration date
04/25/2006
Last updated
09/10/2012
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