Individual
ALLA HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1017 12TH AVE, FORT WORTH, TX 76104-3915
(817) 334-2800
(817) 820-0094
Mailing address
1017 12TH AVE, FORT WORTH, TX 76104-3915
(817) 334-2800
(817) 820-0094
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP133017
TX
Other
Enumeration date
01/18/2017
Last updated
10/12/2021
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