Provider Demographics
NPI:1912373895
Name:STANLEY, AUBREY ELIZABETH (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:ELIZABETH
Last Name:STANLEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 EIGER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8982
Mailing Address - Country:US
Mailing Address - Phone:512-892-7076
Mailing Address - Fax:
Practice Address - Street 1:4534 WEST GATE BLVD STE 108
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1470
Practice Address - Country:US
Practice Address - Phone:512-892-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128252363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
F0220891OtherDPS NUMBER