Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP141127 | TX |
NPI | 1023570231 |
---|---|
Provider Name | Priscilla Ruth James |
First Address | Fort Worth, TX 76161-1205 |
Second Address | Fort Worth, TX 76116-4193 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2019 |
Last Update Date | 20/09/2019 |