Individual
NICOLE MASCARELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN,CPM,LM
Contact information
Practice address
904 E MOORE RD, SAN JUAN, TX 78589-5204
(956) 747-1896
Mailing address
904 E MOORE RD, SAN JUAN, TX 78589
(956) 747-1896
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
329641
TX
176B00000X
Midwife
Primary
99292
TX
Other
Enumeration date
03/24/2016
Last updated
03/27/2023
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