Individual
JOHNNIE MAE IRELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
1919 8TH AVE, FORT WORTH, TX 76110-1358
(817) 332-7722
(817) 900-8675
Mailing address
948 E MULKEY ST, FORT WORTH, TX 76104-6547
(817) 422-8358
(817) 257-7279
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
547683
TX
Other
Enumeration date
05/15/2007
Last updated
03/30/2021
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