Individual
MARY ANN LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6100 HARRIS PARKWAY, SUITE 340, FORT WORTH, TX 76132-4133
(817) 433-5111
(817) 433-5119
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 433-5119
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
454591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280642401
—
TX
01
—
P01019333
RAILROAD MEDICARE
TX
Enumeration date
03/02/2010
Last updated
05/16/2012
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