Individual
MELINDA WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-2965
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-7144
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP139120
TX
Other
Enumeration date
11/30/2018
Last updated
01/24/2019
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