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Individual

KATHY A JAGGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
1250 8TH AVENUE, SUITE 440, FORT WORTH, TX 76104-4144
(817) 923-5558
(817) 921-2701
Mailing address
PO BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 921-2701

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
612285
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141137302
TX
05
141137304
TX
01
500030127
RAILROAD MEDICARE
Enumeration date
07/17/2006
Last updated
09/30/2011
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