Individual
MARY F MCFALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
146001-030
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
27197
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44327600
—
WI
01
—
60251
DEAN HEALTH INSURANCE
WI
Enumeration date
04/19/2006
Last updated
10/27/2020
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