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General NPI Number Information
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NPI Number | 1861779845
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Entity Type | Individual
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Provider Name | MARY B WAINSCOTT CRNA, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 09/14/2024
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Provider Practice Location Address
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Address Line | 101 WINDSOR CIR
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City | WAXAHACHIE
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State | TX
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Zip | 75165-4819
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Country | US
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Telephone | 972-921-8416
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone | 214-648-7833
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 755875
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1174996
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License Number State | TX
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