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Individual
VONDA T STANLEY
Active
Individual
VONDA T STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024116223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010004900
VA PREMIER
VA
05
—
010004900
—
VA
01
—
010105030
VA PREMIER KB
VA
05
—
010105030
—
VA
05
—
010259541
—
VA
01
—
187681
MEDCOST KB
VA
01
—
7000902
NC MEDICAID
VA
01
—
P00255169
SH RR MEDICARE
VA
Enumeration date
06/20/2005
Last updated
03/25/2013
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