Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 000000 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 1015650 | TX |
NPI | 1982215315 |
---|---|
Provider Name | Stefanie Rao Mann |
First Address | Pasadena, TX 77504-2022 |
Second Address | Pasadena, TX 77504-2022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 01/10/2020 |