Individual
KATHRYN CORINNE MORELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
(817) 338-0927
Mailing address
1201 FAIRMOUNT AVE, FORT WORTH, TX 76104-4215
(817) 335-5288
(817) 394-6294
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP121079
TX
363LA2200X
Adult Health Nurse Practitioner
734380
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294313601
—
TX
01
—
734380
TEXAS RN LICENSE
TX
01
—
AP121079
TEXAS NURSE PRACTITIONER LICENSE
TX
Enumeration date
10/30/2011
Last updated
11/01/2023
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