Provider Demographics
NPI:1508194275
Name:STONE, AMANDA CAROL (WHCNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:CAROL
Last Name:STONE
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:CAROL
Other - Last Name:STOECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHCNP
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-2222
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-5302
Practice Address - Country:US
Practice Address - Phone:409-772-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717292363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health