Provider Demographics
NPI:1831256601
Name:MCRAE, MARY STUART (RNFA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:STUART
Last Name:MCRAE
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 PANDALE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7724
Mailing Address - Country:US
Mailing Address - Phone:903-583-0282
Mailing Address - Fax:
Practice Address - Street 1:5420 PANDALE VALLEY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7724
Practice Address - Country:US
Practice Address - Phone:903-583-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX651728163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant