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NPI Code Detail

MEDICARE: MARY FRANCES PACK RNFA

MEDICARE: MARY FRANCES PACK RNFA
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 Nurse573138TX

General Provider Information

NPI Number : 1194756015
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FRANCES PACK RNFA
Provider Business Mailing Address
First Line : 2547 COUNTY ROAD 178
Second Line :
City : STEPHENVILLE
State : TX
Zip : 76401-1498
Country : US
Telephone Number : 254-965-6112
Fax Number :
Provider Business Practice Location Address
First Line : 411 N BELKNAP ST
Second Line :
City : STEPHENVILLE
State : TX
Zip : 76401-3415
Country : US
Telephone Number : 254-965-1500
Fax Number : 254-965-1192
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/08/2007

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Directions to “ MARY FRANCES PACK RNFA” Practice Location

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