Healthcare Provider Details

I. General information

NPI: 1225373244
Provider Name (Legal Business Name): BLUE CLOUDS HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2012
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 N FIELDER RD # A
ARLINGTON TX
76012-5802
US

IV. Provider business mailing address

729 N FIELDER RD # A
ARLINGTON TX
76012-5802
US

V. Phone/Fax

Practice location:
  • Phone: 817-633-3400
  • Fax: 817-633-3401
Mailing address:
  • Phone: 817-633-3400
  • Fax: 817-633-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number843050
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE O'CONNOR
Title or Position: PMHNP-BC, FNP-BC
Credential: DNP
Phone: 817-779-1585