Healthcare Provider Details

I. General information

NPI: 1003467200
Provider Name (Legal Business Name): STEPHANIE R RYNOR I APRN,FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2019
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 S MESQUITE ST
MUENSTER TX
76252-2789
US

IV. Provider business mailing address

3001 FM 2181 STE 300
CORINTH TX
76210-0162
US

V. Phone/Fax

Practice location:
  • Phone: 940-759-2502
  • Fax:
Mailing address:
  • Phone: 940-497-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32078
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number677667
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: