Healthcare Provider Details

I. General information

NPI: 1588893820
Provider Name (Legal Business Name): FRANCISCA EBELE CHIME FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 07/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 BOLTON BOONE DR SUITE B
DESOTO TX
75115-2075
US

IV. Provider business mailing address

2617 BOLTON BOONE DR SUITE B
DESOTO TX
75115-2075
US

V. Phone/Fax

Practice location:
  • Phone: 972-709-1781
  • Fax: 972-709-1782
Mailing address:
  • Phone: 972-709-1781
  • Fax: 972-709-1782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number660115
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: