Healthcare Provider Details

I. General information

NPI: 1508441726
Provider Name (Legal Business Name): FRANCES LYNN MURPHY MOONEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 LAKE ST
FORT WORTH TX
76102-4581
US

IV. Provider business mailing address

1314 LAKE ST
FORT WORTH TX
76102-4581
US

V. Phone/Fax

Practice location:
  • Phone: 817-810-0660
  • Fax:
Mailing address:
  • Phone: 817-810-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number684241
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: