Individual
MARY K FOUQUIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, RN, CNM
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
R887487
MS
367A00000X
Advanced Practice Midwife
Primary
25784
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03285886
—
MS
Enumeration date
02/02/2012
Last updated
05/12/2020
Update your record
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