Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 238321 | TX |
N | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 238321 | TX |
NPI | 1093906265 |
---|---|
Provider Name | Lucinda Mabry |
First Address | Waco, TX 76712-7934 |
Second Address | Waco, TX 76712-7934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 05/08/2007 |