Individual
MARILYN J. HANNAFIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
9202 ELAM RD, SOUTHEAST DALLAS WOMEN'S HEALTH CENTER, DALLAS, TX 75217-4151
(214) 266-1500
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
585550
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140078016
—
TX
05
—
140078019
—
TX
05
—
140078020
—
TX
05
—
140078021
—
TX
05
—
140078022
—
TX
05
—
140078023
—
TX
05
—
140078024
—
TX
05
—
140078025
—
TX
05
—
140078026
—
TX
05
—
140078027
—
TX
05
—
140078028
—
TX
01
—
8Y2909
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/28/2006
Last updated
04/13/2009
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