Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stonewall Fellowship Church

Organization Critical Care Pediatric Nurse Practitioner · NPI 1134088172

Stonewall Fellowship Church provides Critical Care Pediatric Nurse Practitioner services in Nacogdoches, Texas. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

1303 S University Dr
Nacogdoches, TX 75961
Phone: (936) 219-4611
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Pediatric Nurse Practitioner (primary) Taxonomy 363LP0222X

Record details

NPI number1134088172
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Desmond Tolbert — Owner · (936) 219-4611
NPI enumeratedJanuary 16, 2026
Last updated in NPPESJanuary 16, 2026
Certification dateJanuary 13, 2026
Mailing address1303 South University Dr, Nacogdoches, TX 75961