Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 429131 | TX |
NPI | 1083984322 |
---|---|
Provider Name | Diane Craig Turner |
First Address | Ft. Worth, TX 76104 |
Second Address | Ft Worth, TX 76104-4802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 04/01/2012 |