Individual
MARY KATE FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1860 S SEGUIN AVE BLDG E, NEW BRAUNFELS, TX 78130-3914
(210) 232-8886
Mailing address
10004 JOHNS ROAD, BOERNE, TX 78006-8811
(830) 267-4575
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP126803
TX
Other
Enumeration date
02/24/2015
Last updated
09/16/2015
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