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Individual

MARYLOU BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
5001 N PIEDRAS ST, EL PASO, TX 79930-4210
(915) 564-6100
Mailing address
7350 ROSAS WAY, CANUTILLO, TX 79835-6104
(915) 877-4881

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
579631
TX
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
579631
TX
163WW0000X
Wound Care Registered Nurse
Primary
579631
TX

Other

Enumeration date
12/09/2008
Last updated
12/09/2008
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