MEDICARE: MARYANN M EFESOA DNP, FNP-C, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP123893	TX
2	363LF0000X	Family Nurse Practitioner	AP123893	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659703023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANN M EFESOA DNP, FNP-C, PMHNP-BC

Provider Business Mailing Address
First Line	:	2201 SPINKS RD STE 133
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4451
Country	:	US
Telephone Number	:	469-309-7834
Fax Number	:	469-252-7098

Provider Business Practice Location Address
First Line	:	2201 SPINKS RD STE 133
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4451
Country	:	US
Telephone Number	:	469-309-7834
Fax Number	:	469-252-7098

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

Provider Enumeration Date	:	08/07/2013
Last Update Date	:	11/10/2025

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