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General NPI Number Information
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NPI Number | 1548069842
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Entity Type | Individual
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Provider Name | MERISSA TARA MCFADDEN MSN, APRN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 5038 TENNYSON PKWY # 100B
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City | PLANO
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State | TX
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Zip | 75024-2954
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Country | US
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Telephone | 972-200-8144
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Fax | 469-991-7710
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Provider Business Mailing Address
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Address Line | 5038 TENNYSON PKWY STE 100B
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City | PLANO
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State | TX
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Zip | 75024-2954
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Country | US
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Telephone | 972-200-8144
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Fax | 469-991-7710
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 845650
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1192320
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License Number State | TX
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