Provider Demographics
NPI:1952424343
Name:RANCE-MARR, JEANIE STUART (LMT, NCMMT)
Entity Type:Individual
Prefix:MS
First Name:JEANIE
Middle Name:STUART
Last Name:RANCE-MARR
Suffix:
Gender:F
Credentials:LMT, NCMMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 CONCORD DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3010
Mailing Address - Country:US
Mailing Address - Phone:817-354-8686
Mailing Address - Fax:
Practice Address - Street 1:1500 NORWOOD DR BLDG B
Practice Address - Street 2:SUITE 203
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3651
Practice Address - Country:US
Practice Address - Phone:817-917-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT5088174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist