Provider Demographics
NPI:1417249376
Name:PHAREZ, MARYE CYNTHIA (CRNP)
Entity Type:Individual
Prefix:
First Name:MARYE
Middle Name:CYNTHIA
Last Name:PHAREZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:PHAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1100 SCHAUB AVE
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5131
Mailing Address - Country:US
Mailing Address - Phone:251-377-7363
Mailing Address - Fax:
Practice Address - Street 1:5750A SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3316
Practice Address - Country:US
Practice Address - Phone:251-450-5900
Practice Address - Fax:251-662-7297
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1052638163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health