Provider Demographics
NPI:1356916589
Name:MACRI, SIOBHAN MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:SIOBHAN
Middle Name:MARIE
Last Name:MACRI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 FOUNTAINBLEAU LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1101
Mailing Address - Country:US
Mailing Address - Phone:631-312-2964
Mailing Address - Fax:
Practice Address - Street 1:4400 TX-121, STE 600
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056
Practice Address - Country:US
Practice Address - Phone:972-523-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX751104163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse