Provider Demographics
NPI:1518966217
Name:STONE, MARIAN JEANNE (FNP)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:JEANNE
Last Name:STONE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 EAST JEFFERSON
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:972-923-2440
Mailing Address - Fax:972-923-2445
Practice Address - Street 1:411 EAST JEFFERSON
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:972-923-2440
Practice Address - Fax:972-923-2445
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX423807363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148646608Medicaid
TX148646606Medicaid
TX148646607Medicaid
TX148646605Medicaid
TX148646603Medicaid
TX8K6627Medicare PIN
TXTXB125616Medicare PIN
TX148646607Medicaid
TX148646603Medicaid
TXTXB125934Medicare PIN
TX148646606Medicaid