Willard, Fawn Marie
Willard, Fawn Marie is an individual health care provider with primary practice located at 3529 Heritage Trace Pkwy Ste 137 , Fort Worth TX 76244-4971. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Willard, Fawn Marie can be contacted via phone (817) 741-7960.Contact Information
Primary practice address
3529 Heritage Trace Pkwy Ste 137
Fort Worth TX 76244-4971
Phone: (817) 741-7960
Fax: (817) 741-7581
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP126173 | Texas |
Profile Details
| NPI number | 1770556698 |
|---|---|
| LBN Legal business name | Willard, Fawn Marie |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Mar 24th, 2016 - about 9 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 | 1770556698 | NPPES |
| Texas | Other | 869052 | RN LICENSE |
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