| Doctor Name: | MARY ANETA CORLEY |
| NPI Number: | 1326062316 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CFNP |
| License Number: | 437214 |
| Business Practice Address: | 123 N Main St Lone Star, TX - 756682223 |
| Business Phone Number: | 9036560633 |
| Business Fax Number: | 9036560636 |
| Mailing Address: | 204 Dogwood, LONE STAR |
| State: | TX |
| Postal Code: | 756681922 |
| Phone Number: | 9036563792 |
| Fax Number: | 9036563792 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 12/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 437214 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |