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General NPI Number Information
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NPI Number | 1184627655
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Entity Type | Individual
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Provider Name | MARY ANN FORE R.N.C., C.N.M., M.S.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 07/16/2015
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Provider Practice Location Address
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Address Line | 1076 E LOS EBANOS BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-544-2001
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Fax | 956-546-4567
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Provider Business Mailing Address
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Address Line | 1076 E LOS EBANOS BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9988
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Country | US
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Telephone | 956-544-2001
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Fax | 956-546-4567
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 239542
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License Number State | TX
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