Individual
MICHELLE MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2796
(682) 885-4000
Mailing address
1207 ROARING SPRINGS RD, FORT WORTH, TX 76114-4488
(817) 774-7415
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
959402
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1129242
TX
Other
Enumeration date
07/07/2023
Last updated
07/18/2023
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