Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP135488 | TX |
NPI | 1033637483 |
---|---|
Provider Name | Heather Carden |
First Address | Fort Worth, TX 76104-2122 |
Second Address | Fort Worth, TX 76104-2122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2017 |
Last Update Date | 12/11/2019 |