# FORTITUDE PEDIATRIC HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fortitude Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740789742
- **Authorized official:** JENNA MARTIN RN (CO-OWNER)
- **Authorized official phone:** (972) 837-9527

## Contact information

- **Practice address:** 6715 APRICOT LN, FRISCO, TX 75035-7718
- **Practice address phone:** (346) 333-8159
- **Mailing address:** 6715 APRICOT LN, FRISCO, TX 75035-7718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | 803475 | TX | Yes |

## Other

- **Enumeration date:** 02/05/2018
- **Last updated:** 02/05/2018