Provider Demographics
NPI:1073199451
Name:HULSE, MARY CHERIE (NP-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHERIE
Last Name:HULSE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2408 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-4615
Mailing Address - Country:US
Mailing Address - Phone:972-249-6486
Mailing Address - Fax:
Practice Address - Street 1:2408 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-4615
Practice Address - Country:US
Practice Address - Phone:972-249-6486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1032625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily