MEDICARE: DERYLANN C PRICE R.N.,F.N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	254037	TX
2	163WE0003X	Emergency Registered Nurse	254037	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	81N272	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1043223878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DERYLANN C PRICE R.N.,F.N.P.

Provider Business Mailing Address
First Line	:	6508 RICKEY LN
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76001-5522
Country	:	US
Telephone Number	:	817-557-1072
Fax Number	:	817-466-2854

Provider Business Practice Location Address
First Line	:	1017 W RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2513
Country	:	US
Telephone Number	:	817-469-1163
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	09/21/2016

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Directions to “ DERYLANN C PRICE R.N.,F.N.P.” Practice Location

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