Provider Demographics
NPI:1548900483
Name:NUNN, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NUNN
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 1:5911 ECKHERT RD UNIT 117
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3857
Mailing Address - Country:US
Mailing Address - Phone:469-999-1320
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST # C-368
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-7001
Practice Address - Country:US
Practice Address - Phone:859-218-1661
Practice Address - Fax:859-257-7167
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program