Healthcare Provider Details

I. General information

NPI: 1497255152
Provider Name (Legal Business Name): AMANDA RANAY STONE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2018
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E 4TH ST STE 125
FORT WORTH TX
76102-4011
US

IV. Provider business mailing address

3028 MISTY RIDGE LN
ROCKWALL TX
75032-6817
US

V. Phone/Fax

Practice location:
  • Phone: 888-973-8158
  • Fax:
Mailing address:
  • Phone: 903-283-2767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number7711375
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number771375
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: