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NPI Code Detail

MEDICARE: MRS. TAANADEEBA MITEE FNP-BC

MEDICARE:  MRS. TAANADEEBA  MITEE  FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2022014262TX
2363LF0000XFamily Nurse Practitioner1086968TX

General Provider Information

NPI Number : 1316447204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TAANADEEBA MITEE FNP-BC
Provider Business Mailing Address
First Line : 2909 MITCHELL BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-4642
Country : US
Telephone Number : 817-625-4254
Fax Number :
Provider Business Practice Location Address
First Line : 2909 MITCHELL BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76105-4642
Country : US
Telephone Number : 817-625-4254
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2018
Last Update Date : 11/14/2022

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Directions to “ MRS. TAANADEEBA MITEE FNP-BC” Practice Location

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