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General NPI Number Information
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NPI Number | 1922425586
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Entity Type | Organization
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Legal Business Name | IN HOME NURSE PRACTITIONERS
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 4300 PECOS ST
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City | FORT WORTH
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State | TX
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Zip | 76119-5162
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Country | US
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Telephone | 817-706-8415
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19096
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City | FORT WORTH
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State | TX
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Zip | 76119-1096
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Country | US
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Telephone | 817-706-8415
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | AMEISHA JASHON SCOTT
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Credential | RN, MSN, FNP-C
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Telephone | 817-706-8415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 704199
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License Number State | TX
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