Provider Demographics
NPI:1366794497
Name:DANCEL, MA. MARISA SAAVEDRA
Entity type:Individual
Prefix:
First Name:MA. MARISA
Middle Name:SAAVEDRA
Last Name:DANCEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6038 AINSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3536
Mailing Address - Country:US
Mailing Address - Phone:901-361-5207
Mailing Address - Fax:
Practice Address - Street 1:6038 AINSWORTH ST
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3536
Practice Address - Country:US
Practice Address - Phone:901-361-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-13
Last Update Date:2012-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000162193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse