Individual
NANCY A TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
(817) 735-5441
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
(817) 735-5441
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
507107
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
507107
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044358201
—
TX
01
—
500027002
RAILROAD MEDICARE
TX
01
—
87N897
BCBS
TX
Enumeration date
04/19/2006
Last updated
09/26/2011
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