Individual
AUTUMN DEMARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
900 8TH AVE, FORT WORTH, TX 76104-3902
(203) 200-0749
Mailing address
5851 LEGACY CIR STE 600, PLANO, TX 75024-5969
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1064819
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
1064819
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/30/2024
Last updated
05/06/2026
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