Provider Demographics
NPI:1952303547
Name:MARCO, DALE-ANN M (FNP)
Entity Type:Individual
Prefix:MS
First Name:DALE-ANN
Middle Name:M
Last Name:MARCO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:DALE-ANN
Other - Middle Name:M
Other - Last Name:BARFIELD OR STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1320 GREENWAY DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2416
Mailing Address - Country:US
Mailing Address - Phone:972-550-9195
Mailing Address - Fax:972-550-0079
Practice Address - Street 1:1643 LANCASTER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3593
Practice Address - Country:US
Practice Address - Phone:817-329-7670
Practice Address - Fax:817-416-0145
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX421580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P32370Medicare UPIN