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General NPI Number Information
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NPI Number | 1982247722
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Entity Type | Individual
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Provider Name | COMFORT MUDOH CNM, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 3201 MATLOCK RD STE 210
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City | ARLINGTON
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State | TX
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Zip | 76015-2946
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Country | US
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Telephone | 817-468-4689
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Fax |
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Provider Business Mailing Address
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Address Line | 4805 CRUMBCAKE DR
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City | FORT WORTH
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State | TX
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Zip | 76244-4627
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Country | US
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Telephone | 443-527-4985
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1095220
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | LK-0000202
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 1095220
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License Number State | TX
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