Active NPI
Marcelline Mafor
- Licensed Vocational Nurse
- Mansfield, TX
National Provider Identifier
1790306678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 352612
- Practice address
- 4800 San Remo Dr
Mansfield, TX 76063-8642 - Phone
- (678) 622-1415
- NPI assigned
- May 1, 2020
- Last updated
- May 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 352612 | TX | Primary |
Addresses
Primary practice location
4800 San Remo Dr
Mansfield, TX 76063-8642
Mailing address
4800 San Remo Dr
Mansfield, TX 76063-8642
Phone (678) 622-1415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 352612 | TX | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588291200000",
"number": "1790306678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 SAN REMO DR",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760638642",
"telephone_number": "678-622-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAN REMO DR",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760638642",
"telephone_number": "678-622-1415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAFOR",
"first_name": "MARCELLINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-01",
"last_updated": "2020-05-01",
"certification_date": "2020-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "352612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.