Individual
MARY ANGELA MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, ENP, FNP
Contact information
Practice address
1303 ELK RIVER RD, TYLER, TX 75703-7456
(713) 397-9773
Mailing address
1303 ELK RIVER RD, TYLER, TX 75703-7456
(713) 397-9773
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
671796
TX
363L00000X
Nurse Practitioner
Primary
671796
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
671796
LICENSE
TX
Enumeration date
03/11/2008
Last updated
04/17/2017
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