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Individual
MARY L ROY
Active
Individual
MARY L ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-45636
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161346
BLUE CROSS BLUE SHIELD KS
—
05
—
200282590A
—
KS
05
—
200282590C
—
KS
01
—
580690
FIRSTGUARD HEALTH PLAN
—
Enumeration date
09/26/2006
Last updated
03/02/2026
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