Mary Fanselow, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP3378812 Issued in FL

Practice address

311 N Clyde Morris Blvd
Suite 350
Daytona Beach, FL 32114-2781

Phone

(386) 255-1266

Fax

(386) 255-8520

NPI assigned

Jul 15, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Halifax Anesthesiology Associates PA

  • Anesthesiology Physician
  • Daytona Beach, FL
  • NPI 1639194590
  NPD (past)
• Volusia Anesthesia Associates

  • Anesthesiology Physician
  • Daytona Beach, FL
  • NPI 1205862992
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881610459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 350",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-255-1266",
            "fax_number": "386-255-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 350",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142781",
            "telephone_number": "386-255-1266",
            "fax_number": "386-255-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANSELOW",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3378812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Denistry of Daytona Beach, LLC
• Family First Health Center
• Family First Home Care of Florida
• Family Tree Acupuncture PL
• Brandy Fancher
• Peter Farag
• Suzy Sameh Farag, MD
• Ali Faraj
• Valerie Farber, PHARMD
• Linda Montreuil Fares, OTR/L

• Certified Registered Nurse Anesthetist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.