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Ms. Mary Michelle Lively, NP-C
Family Nurse Practitioner in Dallas, Texas
NPI 1114261401

Mary Michelle Lively is a Family Nurse Practitioner based in Dallas, TX and is specialized in Family. Mary Michelle Lively practices in Dallas, TX and has the professional credentials of NP-C. The NPI Number for Mary Michelle Lively is 1114261401 and holds a License No. AP122051 (Texas).

The current practice location address for Mary Michelle Lively is 8198 Walnut Hill Ln Ste 100, Dallas, TX and can be reached out via phone at 214-345-4449 and via fax at 214-345-1238.

Location: 8198 Walnut Hill Ln Ste 100, Dallas, TX, 75231-4316
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Provider Profile Details
NPI Number
1114261401
Provider Name
Mary Michelle Lively
Credential
NP-C
Provider Entity Type
Individual
Gender
Female
Address
8198 Walnut Hill Ln Ste 100, Dallas, TX, 75231-4316
Phone Number
214-345-4449
Fax Number
214-345-1238
Provider Enumeration Date
11/27/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8543NH 01 TX BCBS TX
338206102 05 TX
338206103 05 TX
institution
Provider Business Practice Location Address Details
Address
8198 Walnut Hill Ln Ste 100
City
State
Zip
75231-4316
Phone Number
214-345-4449
Fax Number
214-345-1238
person
Provider Business Mailing Address Details
Address
8198 Walnut Hill Ln Ste 100
City
State
Zip
75231-4316
Phone Number
214-345-4449
Fax Number
214-345-1238
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
AP122051 (Texas)
Definition
Definition to come...
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