Individual
MS. DEBRA WILKINSON-FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 921-3431
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 921-3431
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
238594
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143391402
—
TX
Enumeration date
07/20/2006
Last updated
11/30/2010
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