Provider Demographics
NPI:1376128116
Name:TABONE, STEPHANIE MARIAN (CNP-FNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIAN
Last Name:TABONE
Suffix:
Gender:F
Credentials:CNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 MCCANDLESS ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2213
Mailing Address - Country:US
Mailing Address - Phone:512-797-1746
Mailing Address - Fax:
Practice Address - Street 1:2500 S LAKELINE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2968
Practice Address - Country:US
Practice Address - Phone:512-345-8970
Practice Address - Fax:855-220-9655
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily