Individual
MS. ODDETH ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RN-BC, NP
Contact information
Practice address
431 FULTON ST, FORT WORTH, TX 76104-2214
(817) 336-0754
(817) 336-0651
Mailing address
431 FULTON ST, FORT WORTH, TX 76104-2214
(817) 336-0754
(817) 336-0651
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
462492
TX
Other
Enumeration date
08/03/2006
Last updated
07/18/2007
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