Provider Demographics
NPI:1396910899
Name:STONE, KATHRYN LONG (CNS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LONG
Last Name:STONE
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:901 W 38TH ST STE 200
Practice Address - Street 2:SOUTHWEST REGIONAL CANCER CENTER
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1165
Practice Address - Country:US
Practice Address - Phone:512-421-4100
Practice Address - Fax:512-419-0924
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2007004574364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196754902Medicaid
TX196754901Medicaid
TX8L1686Medicare PIN
TX8L1687Medicare PIN