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Individual
MARY COUTURE
Active
Individual
MARY COUTURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001535
IA
363A00000X
Physician Assistant
Primary
1056
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17293
WELLMARK BCBS
—
01
—
242918
MIDLANDS CHOICE
—
05
—
6827720
—
SD
Enumeration date
06/21/2006
Last updated
06/08/2015
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