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NPI Code Detail

MEDICARE: KARA MARIE WILLDEN

MEDICARE:   KARA MARIE WILLDEN
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
1363LF0000XFamily Nurse PractitionerAP145289TX

General Provider Information

NPI Number : 1801411277
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA MARIE WILLDEN
Provider Business Mailing Address
First Line : 6503 W SHADY SHORES RD APT 717
Second Line :
City : DENTON
State : TX
Zip : 76208-5565
Country : US
Telephone Number : 940-867-8693
Fax Number :
Provider Business Practice Location Address
First Line : 240 E RENFRO ST STE 204
Second Line :
City : BURLESON
State : TX
Zip : 76028-3940
Country : US
Telephone Number : 817-968-5756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2020
Last Update Date : 10/12/2021

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Directions to “ KARA MARIE WILLDEN ” Practice Location

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