Provider Demographics
NPI:1831505957
Name:STANLEY, BRENDA JOY (MSN, NNP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JOY
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MSN, NNP
Other - Prefix:MISS
Other - First Name:BRENDA
Other - Middle Name:JOY
Other - Last Name:COLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5414 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3641
Mailing Address - Country:US
Mailing Address - Phone:210-541-8281
Mailing Address - Fax:210-541-9123
Practice Address - Street 1:5414 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3641
Practice Address - Country:US
Practice Address - Phone:210-541-8281
Practice Address - Fax:210-541-9123
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX626839363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal