Provider Demographics
NPI:1326319492
Name:PROPER, MARY ANN (RN CWOCN)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:PROPER
Suffix:
Gender:F
Credentials:RN CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 STIPPA RD
Mailing Address - Street 2:
Mailing Address - City:COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12051-1819
Mailing Address - Country:US
Mailing Address - Phone:518-731-9472
Mailing Address - Fax:
Practice Address - Street 1:36 STIPPA RD
Practice Address - Street 2:
Practice Address - City:COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12051-1819
Practice Address - Country:US
Practice Address - Phone:518-731-9472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-22
Last Update Date:2012-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381083-1163W00000X
NY2005455470163WC2100X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care