Individual
RACHEL MARIE FANOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 702-6500
(817) 927-3872
Mailing address
PO BOX 732973, DALLAS, TX 75373-2973
(817) 702-2450
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
718375
TX
367A00000X
Advanced Practice Midwife
Primary
AP120600
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287016403
—
TX
01
—
8105NS
BCBS
TX
Enumeration date
05/18/2011
Last updated
03/17/2018
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