Fanous, Rachel Marie

Fanous, Rachel Marie is an individual health care provider with primary practice located at 1500 S Main St , Fort Worth TX 76104-4917. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Fanous, Rachel Marie can be contacted via phone (817) 702-6500.

Contact Information

Primary practice address
1500 S Main St Fort Worth TX 76104-4917
Phone: (817) 702-6500
Fax: (817) 927-3872
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 718375 Texas
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X AP120600 Texas

Profile Details

NPI number 1609169085
LBN Legal business name Fanous, Rachel Marie
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2011
Last updated Mar 17th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609169085 NPPES
Texas MEDICAID 287016403
Texas Other 8105NS

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