Provider Demographics
NPI:1205139920
Name:CURTIS, MARY PATRICIA (RN NP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:PATRICIA
Last Name:CURTIS
Suffix:
Gender:F
Credentials:RN NP-C
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN, MSN, PHD, NP-C
Mailing Address - Street 1:713 REDSTART DR
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63021
Mailing Address - Country:US
Mailing Address - Phone:636-230-5646
Mailing Address - Fax:
Practice Address - Street 1:713 REDSTART DR
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63021-4777
Practice Address - Country:US
Practice Address - Phone:636-230-5646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO075955363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health