Provider Demographics
NPI:1356557219
Name:STONER, MARY C (PNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:C
Last Name:STONER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 AUSTIN CENTER BLVD
Mailing Address - Street 2:SPECIALLY FOR CHILDREN
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3146
Mailing Address - Country:US
Mailing Address - Phone:512-628-1850
Mailing Address - Fax:512-628-1851
Practice Address - Street 1:6811 AUSTIN CENTER BLVD
Practice Address - Street 2:SPECIALLY FOR CHILDREN
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3146
Practice Address - Country:US
Practice Address - Phone:512-628-1850
Practice Address - Fax:512-628-1851
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229031363LP0200X, 364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics