Individual
NAOMI MPUTU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7609 MEADOWLARK DR, FORT WORTH, TX 76133-7939
(443) 528-9366
Mailing address
7609 MEADOWLARK DR, FORT WORTH, TX 76133-7939
(443) 528-9366
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
652275
NY
163W00000X
Registered Nurse
R196685
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1069023
TX
Other
Enumeration date
01/09/2012
Last updated
02/15/2022
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