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NPI Code Detail

MEDICARE: MS. MARY BIASIOLLI R.N.

MEDICARE: MS. MARY BIASIOLLI R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse227628TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1227628OTHERTXRN LICENSE

General Provider Information

NPI Number : 1538234265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY BIASIOLLI R.N.
Provider Business Mailing Address
First Line : PO BOX 1052
Second Line :
City : BURLESON
State : TX
Zip : 76097-1052
Country : US
Telephone Number : 817-295-3247
Fax Number : 817-295-6777
Provider Business Practice Location Address
First Line : 1000 9TH AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-3906
Country : US
Telephone Number : 817-295-3247
Fax Number : 817-295-6777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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