# STANLEY MATTHEWS NINAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1700039005
- **Gender:** Man
- **Credential:** APN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 684424 | TX | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | 684424 | TX | — |

## Other

- **Enumeration date:** 10/30/2008
- **Last updated:** 03/30/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 199861901 | — | TX |
| 01 | — | 8Y9056 | BCBS | TX |
| 01 | — | P00723851 | RR MEDICARE | TX |