Individual
NIPA CHAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
801 7TH AVE, FORT WORTH, TX 76104-2733
(682) 885-7918
(682) 885-3825
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
733075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20082203-PC
PNP CERTIFICATION
—
05
—
281044202
—
TX
Enumeration date
03/06/2009
Last updated
09/13/2011
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