Bostic, Tawanda Nitchelle
Bostic, Tawanda Nitchelle is an sole proprietor health care provider with primary practice located at 6000 Western Pl , Fort Worth TX 76107-4607. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bostic, Tawanda Nitchelle can be contacted via phone (704) 641-7475.Contact Information
Primary practice address
6000 Western Pl
Fort Worth TX 76107-4607
Phone: (704) 641-7475
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Medical-Surgical | 163WM0705X | 196483 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN-LIC-127603 | Montana |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 196483 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 196483 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | AP60975928 | Washington |
Profile Details
| NPI number | 1154576197 |
|---|---|
| LBN Legal business name | Bostic, Tawanda Nitchelle |
| Credentials | FNP-BC/PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 18th, 2008 |
| Last updated | Sep 3rd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154576197 | NPPES |
| North Carolina | Other | 196483 | NCBON- RN LICENSE |
| North Carolina | Other | 2008006354 | NCBON- RN LICENSE |
| North Carolina | Other | 2013020566 | NCBON- RN LICENSE |
| North Carolina | Other | APRN-LIC-127603 | NCBON- RN LICENSE |
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