Individual
CHARITY JOLYNN STAUTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4701 BRYANT IRVIN RD N, FORT WORTH, TX 76107-7627
(817) 702-1762
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-1100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21680
CA
363LF0000X
Family Nurse Practitioner
AP133775
TX
Other
Enumeration date
02/24/2012
Last updated
07/21/2022
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