Stonewall Fellowship Church

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

Legal business name

STONEWALL FELLOWSHIP CHURCH

Practice address

1303 South University Dr
Nacogdoches, TX 75961

Phone

(936) 219-4611

NPI assigned

Jan 16, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Desmond Tolbert

Title

Owner

Phone

(936) 219-4611

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1134088172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 SOUTH UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "936-219-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 SOUTH UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "75961",
            "telephone_number": "936-219-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONEWALL FELLOWSHIP CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "TOLBERT",
        "authorized_official_first_name": "DESMOND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-219-4611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stockman Pain Services PLLC
• James Robert Stockman Jr., CRNA
• Kendra Brooks Stockman, CRNA
• Grace Leanne Stockwell, PTA
• Stone Fort Inpatient Services PLLC
• Stonewall Pediatric Health Center, LLC
• Barbara Stracener, RN
• Striplings Pharmacy LLC
• Striplings Pharmacy, LLC
• Strive Clinical Network Inc

• Critical Care Pediatric Nurse Practitioner in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Critical Care Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.