Provider Demographics
NPI:1528615275
Name:CANO, MARYANN THERESA
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:THERESA
Last Name:CANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ALERO CIR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-0808
Mailing Address - Country:US
Mailing Address - Phone:505-891-1545
Mailing Address - Fax:
Practice Address - Street 1:204 ALERO CIR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-0808
Practice Address - Country:US
Practice Address - Phone:505-891-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider