Healthcare Provider Details
I. General information
NPI: 1346612769
Provider Name (Legal Business Name): FENI STANLEY JOHN RN-FNP, AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/25/2015
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5308 N GALLOWAY AVE STE 201
MESQUITE TX
75150-1125
US
IV. Provider business mailing address
440 FENWICK DR
SUNNYVALE TX
75182-3222
US
V. Phone/Fax
- Phone: 469-800-3200
- Fax:
- Phone: 972-203-8096
- Fax: 972-203-8096
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | AP129044 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | 2021161511 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: