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General NPI Number Information
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NPI Number | 1619554664
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Entity Type | Individual
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Provider Name | CATHERINE M STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2021
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 5925 CONVAIR DR STE 509
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City | FORT WORTH
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State | TX
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Zip | 76109-1276
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Country | US
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Telephone | 817-349-7541
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 CONVAIR DR STE 509
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City | FORT WORTH
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State | TX
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Zip | 76109-1276
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Country | US
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Telephone | 817-349-7541
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Fax | 817-349-7549
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F03210688
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License Number State | TX
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