MEDICARE: PEGGY PAIS RN, MSN, CNS-BC,APRN

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
1	364SA2200X	Adult Health Clinical Nurse Specialist	AP120110	TX

General Provider Information

NPI Number	:	1376834499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY PAIS RN, MSN, CNS-BC,APRN

Provider Business Mailing Address
First Line	:	1706 FM 1431
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4954
Country	:	US
Telephone Number	:	512-588-8197
Fax Number	:	830-201-4092

Provider Business Practice Location Address
First Line	:	1706 FM 1431
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4954
Country	:	US
Telephone Number	:	512-588-8197
Fax Number	:	830-201-4092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2011
Last Update Date	:	04/21/2015

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