Provider Demographics
NPI:1669940383
Name:NSIONU, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NSIONU
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 1:18731 BEARDSLEY CV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-1655
Mailing Address - Country:US
Mailing Address - Phone:443-540-1854
Mailing Address - Fax:
Practice Address - Street 1:18731 BEARDSLEY CV
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-1655
Practice Address - Country:US
Practice Address - Phone:443-540-1854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX919491163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse