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Individual
STANLEY MATTHEWS NINAN
Active
Individual
STANLEY MATTHEWS NINAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
684424
TX
363LA2200X
Adult Health Nurse Practitioner
684424
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199861901
—
TX
01
—
8Y9056
BCBS
TX
01
—
P00723851
RR MEDICARE
TX
Enumeration date
10/30/2008
Last updated
03/30/2011
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