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Individual

BRADEN CHASE WILLBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
601 W TERRELL AVE, FORT WORTH, TX 76104-3243
(817) 702-3100
(817) 702-4847
Mailing address
1009 CRAZY HORSE TRAIL, BURLESON, TX 76028
(214) 300-1913

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
769503
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1138350
TX

Other

Enumeration date
04/25/2022
Last updated
10/19/2023
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