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Individual

COLLEEN KATHLEEN STEPHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, APRN, AGNP,GNP

Contact information

Practice address
6901 MEDICAL PKWY, WACO, TX 76712-7910
(254) 751-4242
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
257249
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP115002
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
185280801
TX
Enumeration date
03/02/2007
Last updated
08/10/2021
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