MEDICARE: MRS. RUTH ELLEN JOY EASTER FNP-C

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	AP134855	TX

General Provider Information

NPI Number	:	1568970192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUTH ELLEN JOY EASTER FNP-C

Provider Business Mailing Address
First Line	:	12075 NOELLE WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-9170
Country	:	US
Telephone Number	:	817-715-5648
Fax Number	:

Provider Business Practice Location Address
First Line	:	2432 AVONDALE HASLET RD STE 100
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-3446
Country	:	US
Telephone Number	:	817-928-3149
Fax Number	:

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

Provider Enumeration Date	:	01/17/2018
Last Update Date	:	12/12/2025

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