Individual
EBONY CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGPCNP-BC, RN
Contact information
Practice address
9696 SKILLMAN ST SUITE 220, DALLAS, TX 75243
(469) 399-0380
Mailing address
2552 PETTUS DR, FORNEY, TX 75126-4158
(469) 399-0380
(469) 925-2137
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP132893
TX
363LP2300X
Primary Care Nurse Practitioner
Primary
AP132893
TX
Other
Enumeration date
12/28/2016
Last updated
08/10/2022
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