=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356253140
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEREDITH KYLE THRASHER APRN, CPNP-AC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2026
-----------------------------------------------------
Last Update Date | 09/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2201 CHESNEE RD
-----------------------------------------------------
City | FORT WORTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76108-2243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-517-7727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2201 CHESNEE RD
-----------------------------------------------------
City | FORT WORTH
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76108-2243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-517-7727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0222X
-----------------------------------------------------
Taxonomy Name | Critical Care Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 1249292
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------