Individual
MRS. JENNY SIMONE EARLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AG-ACNP-BC
Contact information
Practice address
3101 N TARRANT PKWY, FORT WORTH, TX 76177-8601
(405) 249-8209
Mailing address
3101 N TARRANT PKWY, FORT WORTH, TX 76177-8601
(817) 347-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
783608
TX
Other
Enumeration date
02/10/2019
Last updated
02/10/2019
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