Provider Demographics
NPI:1457609000
Name:STRAITWELL, MARILYN ANN (RN, CSA)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:ANN
Last Name:STRAITWELL
Suffix:
Gender:F
Credentials:RN, CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 CLEAR LAKE CITY BLVD.
Mailing Address - Street 2:SUITE 180-213
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062
Mailing Address - Country:US
Mailing Address - Phone:281-224-4861
Mailing Address - Fax:866-826-9232
Practice Address - Street 1:2323 CLEAR LAKE CITY BLVD.
Practice Address - Street 2:SUITE 180-213
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062
Practice Address - Country:US
Practice Address - Phone:281-224-4861
Practice Address - Fax:866-826-9232
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX695972163W00000X
246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist