Stefanie Funderburke, RN

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

934981 Issued in TX

Practice address

3080 College St
Beaumont, TX 77701-4606

Phone

(409) 212-5000

NPI assigned

Mar 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1647043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1154079820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 PERKINS CROSSING DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773046813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 COLLEGE ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014606",
            "telephone_number": "409-212-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2317 Perkins Crossing Dr",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773046813",
            "country_code": "US",
            "telephone_number": "713-805-4821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNDERBURKE",
        "first_name": "STEFANIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-12",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "934981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie French, LMT
• Frio Hospital District
• Yanara Frometa Perez, RN,FNP-C
• Rebecca Fronzaglio
• Shannon Frugia, AU.D.
• Alexandra Susan Furey
• Paul Scott Fusilier, CRNA
• G E Groves MD PA
• G&V Hospice Inc.
• Sherrie Elaine Gaddis, NP

• Medical-Surgical Registered Nurse in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Medical-Surgical Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; 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.