Individual
GINA ROSE BATHURST NORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1105 CENTRAL EXPY N, SUITE 375, ALLEN, TX 75013-6103
(972) 747-5830
(972) 747-5841
Mailing address
1905 WAKEFIELD LN, BLOOMINGTON, IL 61704-9197
(214) 709-7568
(469) 277-3190
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036137448
IL
207L00000X
Anesthesiology Physician
N7777
TX
Other
Enumeration date
02/11/2008
Last updated
09/24/2020
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