MEDICARE: SUSHILA MISHRA FNP

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	1076138	TX

General Provider Information

NPI Number	:	1144825787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSHILA MISHRA FNP

Provider Business Mailing Address
First Line	:	4700 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1058
Country	:	US
Telephone Number	:	214-206-4706
Fax Number	:	888-635-4503

Provider Business Practice Location Address
First Line	:	4700 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1058
Country	:	US
Telephone Number	:	214-206-4706
Fax Number	:	888-635-4503

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

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	01/20/2026

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