Provider Demographics
NPI:1023569886
Name:STUMPENHAUS, ANASTASIA (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:STUMPENHAUS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 BAYRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-9206
Mailing Address - Country:US
Mailing Address - Phone:832-385-7803
Mailing Address - Fax:
Practice Address - Street 1:495 W MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4217
Practice Address - Country:US
Practice Address - Phone:281-332-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132218363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care