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General NPI Number Information
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NPI Number | 1366812562
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Entity Type | Individual
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Provider Name | LETITIA RACHEL STEWART CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 11801 SOUTH FWY
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City | BURLESON
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State | TX
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Zip | 76028-7021
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Country | US
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Telephone | 817-293-9110
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Fax |
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Provider Business Mailing Address
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Address Line | 409 ARBOR GLEN CT
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City | FORT WORTH
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State | TX
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Zip | 76140-5551
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Country | US
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Telephone | 817-371-9369
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | SP015377
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN247227
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015428
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP128057
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP128057
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License Number State | TX
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