Provider Demographics
NPI:1851184089
Name:TITUS, WANDA MADELINE (RN-BSN)
Entity type:Individual
Prefix:MRS
First Name:WANDA
Middle Name:MADELINE
Last Name:TITUS
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:MISS
Other - First Name:WANDA
Other - Middle Name:MADELINE
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5519 SHORTHORN DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-6179
Mailing Address - Country:US
Mailing Address - Phone:786-546-2391
Mailing Address - Fax:
Practice Address - Street 1:1700 E SAUNDERS ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5474
Practice Address - Country:US
Practice Address - Phone:956-796-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN1128946163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical