Mrs. Dana Jean Leatherwood
Nurse Practitioner - Psychiatric/Mental Health
1301 Pennsylvania Ave
Fort Worth
, Texas 76104-2122
Mrs. Dana Jean Leatherwood
Nurse Practitioner - Psychiatric/Mental Health
1301 Pennsylvania Ave
Fort Worth
, Texas 76104-2122
(817) 250-2084
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Mrs. Dana Jean Leatherwood
- 1301 Pennsylvania Ave
- Fort Worth, TX
- Zip : 76104-2122
- Phone : (817) 250-2084
Second Address
- Mrs. Dana Jean Leatherwood
- 1301 Pennsylvania Ave
- Fort Worth, TX
- Zip : 76104-2122
- Phone : (817) 250-2084
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 547178 | TX |
National Provider Identifier
| NPI | 1023203726 |
|---|---|
| Provider Name | Mrs. Dana Jean Leatherwood |
| First Address | Fort Worth, TX 76104-2122 |
| Second Address | Fort Worth, TX 76104-2122 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/09/2007 |
| Last Update Date | 18/11/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 8Y3083 | BLUE CROSS BLUE SHIELD (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.