Individual
CAITLYN JEANETTE BASTABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-3953
(682) 885-7445
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1860
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP139872
TX
Other
Enumeration date
12/18/2018
Last updated
10/01/2024
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