Individual
ASHLEY MARIE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1250 8TH AVE STE 320, FORT WORTH, TX 76104-4139
(817) 924-2111
(817) 546-3980
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8450
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP140391
TX
Other
Enumeration date
01/24/2019
Last updated
03/08/2019
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