Provider Demographics
NPI:1962828533
Name:WEINMAN, STACY DELYNNE (RN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:DELYNNE
Last Name:WEINMAN
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:DELYNNE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 4439
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4439
Mailing Address - Country:US
Mailing Address - Phone:713-792-2991
Mailing Address - Fax:
Practice Address - Street 1:1515 HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-792-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717024363LF0000X
TXAP125456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX330332304OtherMEDICAID CSHCN
TXQ00176539OtherRAILROAD MEDICARE
TX8QN221OtherBCBS
TX330332303Medicaid