Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Theresa Fantazia, DNP

Individual provider Certified Registered Nurse Anesthetist · NPI 1619704947

Mary Theresa Fantazia, DNP is a Certified Registered Nurse Anesthetist (CRNA) in Temple, Texas. Qualified in 2024, 2 years ago. Practices with Scott and White Clinic, a 2,429-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
2
Licensed in
TX
In the registry since
2024
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

2401 S 31st St
Temple, TX 76508-5060
Phone: (254) 724-2111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 1170828 (TX)

Record details

NPI number1619704947
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP
Sole proprietorYes
NPI enumeratedSeptember 19, 2024
Last updated in NPPESAugust 4, 2025
Certification dateAugust 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Scott And White Clinic — 2429 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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