Individual
CARRA MICHELLE DEDUSEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1350 S MAIN ST STE 3300, FORT WORTH, TX 76104-7655
(817) 702-4925
Mailing address
1617 HEMPHILL ST, FORT WORTH, TX 76104-4709
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP127513
TX
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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