Provider Demographics
NPI:1083992275
Name:WRENN, MARY BETH HUNT (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY BETH
Middle Name:HUNT
Last Name:WRENN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:BETH
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 3266
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73702-3266
Mailing Address - Country:US
Mailing Address - Phone:580-233-0650
Mailing Address - Fax:580-249-5999
Practice Address - Street 1:2501 MERCER DR
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-8602
Practice Address - Country:US
Practice Address - Phone:580-233-0650
Practice Address - Fax:580-249-5999
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0035065163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health