Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP132218 | TX |
NPI | 1023569886 |
---|---|
Provider Name | Anastasia Stumpenhaus |
First Address | League City, TX 77573-9206 |
Second Address | Webster, TX 77598-4217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2016 |
Last Update Date | 17/10/2016 |